Healthcare Provider Details

I. General information

NPI: 1700635612
Provider Name (Legal Business Name): LAUREN MICHELLE BROWN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 EAST BLVD STE E
CHARLOTTE NC
28203-5876
US

IV. Provider business mailing address

1235 EAST BLVD STE E
CHARLOTTE NC
28203-5876
US

V. Phone/Fax

Practice location:
  • Phone: 704-931-1083
  • Fax:
Mailing address:
  • Phone: 609-222-5293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number26NR18432700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF08260822
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number26NR18432700
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number26NR18432700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: