Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | RN140457 | GA |
NPI | 1164855284 |
---|---|
Provider Name | Sirlena Elizabeth Brown |
First Address | Albany, GA 31701-1985 |
Second Address | Albany, GA 31701-1943 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2013 |
Last Update Date | 13/08/2013 |