Healthcare Provider Details
I. General information
NPI: 1497265227
Provider Name (Legal Business Name): ELIZABETH MARY BROWN CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/06/2017
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
140 DAMERON AVE
KNOXVILLE TN
37917-6413
US
IV. Provider business mailing address
6350 W ANDREW JOHNSON HWY DEPT 100
TALBOTT TN
37877-8605
US
V. Phone/Fax
- Phone: 865-934-6100
- Fax: 865-342-0100
- Phone: 800-355-3565
- Fax: 423-714-2355
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN207376 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | APN23248 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: