Healthcare Provider Details

I. General information

NPI: 1477893832
Provider Name (Legal Business Name): CYNTHIA AMBER BROWN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2013
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3245 HENDERSON DR
JACKSONVILLE NC
28546-5251
US

IV. Provider business mailing address

225 S US HIGHWAY 1
TEQUESTA FL
33469-2701
US

V. Phone/Fax

Practice location:
  • Phone: 910-937-0008
  • Fax: 910-937-0098
Mailing address:
  • Phone: 561-747-4464
  • Fax: 561-747-5598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9407685
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5006090
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: