Provider Demographics
NPI:1144747312
Name:BROWN, PATRICK T (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:T
Last Name:BROWN
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12461 VETERANS MEMORIAL HWY STE 777
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2025
Mailing Address - Country:US
Mailing Address - Phone:833-366-3934
Mailing Address - Fax:470-867-2636
Practice Address - Street 1:9841 WASHINGTONIAN BLVD STE 200-1065
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-5389
Practice Address - Country:US
Practice Address - Phone:833-366-3934
Practice Address - Fax:470-867-2636
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA24183650363LP0808X
MDRR206729363LP0808X
GARN281860363LP0808X
DCRN1058910363LP0808X
MDAC003349363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health