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General NPI Number Information
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NPI Number | 1174945588
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Entity Type | Organization
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Legal Business Name | EXTRAORDINARY FAMILY HEALTHCARE
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 2330 SCENIC HWY S STE 707
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 678-542-7488
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Fax | 404-481-2688
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Provider Business Mailing Address
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Address Line | 2330 SCENIC HWY S STE 707
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 678-608-2426
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Fax | 404-481-2688
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. BRANDY BROWN
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Credential | DNP, APRN, FNP-C
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Telephone | 678-542-7488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | RN197433
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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