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General NPI Number Information
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NPI Number | 1932974573
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Entity Type | Individual
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Provider Name | CHARNETTE PATRICE BROWN LPN
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Gender | Female
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Dates
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Enumeration Date | 11/22/2023
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 3550 PLEASANT HILL RD APT 214
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City | DULUTH
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State | GA
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Zip | 30096-4871
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Country | US
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Telephone | 404-707-0590
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2884
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City | NORCROSS
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State | GA
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Zip | 30091-2884
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Country | US
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Telephone | 404-707-0590
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN094745
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License Number State | GA
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