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General NPI Number Information
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NPI Number | 1508643982
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Entity Type | Individual
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Provider Name | MS. MARY BROWN
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Gender | Female
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 1310 24TH AVE S
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City | NASHVILLE
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State | TN
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Zip | 37212-2637
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Country | US
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Telephone | 615-225-3720
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Fax |
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Provider Business Mailing Address
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Address Line | 2124 SANTA FE CIRCLE
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City | ARNOLD
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State | MO
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Zip | 63010
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Country | US
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Telephone | 314-347-8231
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2023036418
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License Number State | MO
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