MEDICARE: MR. FRANK A BROWN CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	55340	KS
2	367500000X	Certified Registered Nurse Anesthetist	RN135363	GA
3	367500000X	Certified Registered Nurse Anesthetist	1-085935	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063418200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANK A BROWN CRNA

Provider Business Mailing Address
First Line	:	1210 JACKSONS WAY SW
Second Line	:
City	:	JACKSONVILLE
State	:	AL
Zip	:	36265-4305
Country	:	US
Telephone Number	:	256-435-6999
Fax Number	:	256-435-6999

Provider Business Practice Location Address
First Line	:	1210 JACKSONS WAY SW
Second Line	:
City	:	JACKSONVILLE
State	:	AL
Zip	:	36265-4305
Country	:	US
Telephone Number	:	256-435-6999
Fax Number	:	256-435-6999

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	09/09/2022

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Directions to “ MR. FRANK A BROWN CRNA” Practice Location

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