Provider Demographics
NPI:1093996506
Name:BROWN, SHANDA RENEE (APRN)
Entity Type:Individual
Prefix:
First Name:SHANDA
Middle Name:RENEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1010 GLENBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-1230
Mailing Address - Country:US
Mailing Address - Phone:615-590-1018
Mailing Address - Fax:616-590-1019
Practice Address - Street 1:1010 GLENBROOK WAY
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-1230
Practice Address - Country:US
Practice Address - Phone:615-590-1018
Practice Address - Fax:616-590-1019
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN13026363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily