=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598424731
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TERRY DANAE BROWN CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2021
-----------------------------------------------------
Last Update Date | 04/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 SIVLEY ROAD SW 8TH FLOOR NEURO ICU
-----------------------------------------------------
City | HUNTSVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-265-6644
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 SIVLEY ROAD SW 8TH FLOOR NEURO ICU
-----------------------------------------------------
City | HUNTSVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-529-0353
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 1-155893
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------