Provider Demographics
NPI:1225564917
Name:DOEBEREINER-BROWN, DANIELLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:DOEBEREINER-BROWN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:5957 SUTTON DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-2285
Mailing Address - Country:US
Mailing Address - Phone:770-374-5765
Mailing Address - Fax:
Practice Address - Street 1:3872 GA-5
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135
Practice Address - Country:US
Practice Address - Phone:770-374-5765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GANCO-000003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily