Provider Demographics
NPI:1376978684
Name:BROWN, CHRISTINE MELINDA (AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MELINDA
Last Name:BROWN
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 THORNWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-6739
Mailing Address - Country:US
Mailing Address - Phone:229-242-9240
Mailing Address - Fax:
Practice Address - Street 1:2412 N OAK ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2567
Practice Address - Country:US
Practice Address - Phone:229-244-1400
Practice Address - Fax:229-244-5512
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN123578363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health