Provider Demographics
NPI:1497091326
Name:BROWN, LINDSEY MICHELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:BURGESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2118 SCENIC HWY N
Mailing Address - Street 2:SUITE H
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2633
Mailing Address - Country:US
Mailing Address - Phone:770-558-6017
Mailing Address - Fax:
Practice Address - Street 1:2118 SCENIC HWY N
Practice Address - Street 2:SUITE H
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2633
Practice Address - Country:US
Practice Address - Phone:770-558-6017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-20
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2770363AM0700X
GA7130363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical