Healthcare Provider Details

I. General information

NPI: 1780006304
Provider Name (Legal Business Name): SHATEKA BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2014
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2138
ANTIOCH TN
37011-2138
US

IV. Provider business mailing address

PO BOX 2138
ANTIOCH TN
37011-2138
US

V. Phone/Fax

Practice location:
  • Phone: 615-293-8470
  • Fax:
Mailing address:
  • Phone: 615-293-8470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number183241
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number42216
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: