Healthcare Provider Details

I. General information

NPI: 1023098167
Provider Name (Legal Business Name): BRIAN G BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

384D CARRIAGE HOUSE DRIVE
JACKSON TN
38305-2268
US

IV. Provider business mailing address

384D CARRIAGE HOUSE DRIVE
JACKSON TN
38305-2268
US

V. Phone/Fax

Practice location:
  • Phone: 731-256-2006
  • Fax: 731-256-2007
Mailing address:
  • Phone: 731-256-2006
  • Fax: 731-256-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number7296
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7296
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: