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NPI Code Detail

MEDICARE: WILLIAM JUDE BROWN PHD, FNP

MEDICARE: WILLIAM JUDE BROWN PHD, FNP
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
1363LF0000XFamily Nurse Practitioner229304MA

General Provider Information

NPI Number : 1205810074
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM JUDE BROWN PHD, FNP
Provider Business Mailing Address
First Line : 6600 VAN AALST BLVD
Second Line :
City : FORT BENNING
State : GA
Zip : 31905-2102
Country : US
Telephone Number : 762-408-0311
Fax Number :
Provider Business Practice Location Address
First Line : 6600 VAN AALST BLVD
Second Line :
City : FORT BENNING
State : GA
Zip : 31905-2102
Country : US
Telephone Number : 762-408-0311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 06/24/2025

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