Healthcare Provider Details

I. General information

NPI: 1205831195
Provider Name (Legal Business Name): MONICA RENEE' BROWN M.S.N.,F.N.P-C, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 GLENWOOD DR
THOMASVILLE GA
31792-3818
US

IV. Provider business mailing address

1301 GLENWOOD DR
THOMASVILLE GA
31792-3818
US

V. Phone/Fax

Practice location:
  • Phone: 229-229-2929
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN112057
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: