Provider Demographics
NPI:1508531872
Name:BROWN, TAMATHA JO (ARNP-PMHNP)
Entity Type:Individual
Prefix:
First Name:TAMATHA
Middle Name:JO
Last Name:BROWN
Suffix:
Gender:F
Credentials:ARNP-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 EAST BAY DRIVE
Mailing Address - Street 2:SUITE 204, MB 300,
Mailing Address - City:33764
Mailing Address - State:FL
Mailing Address - Zip Code:33771
Mailing Address - Country:US
Mailing Address - Phone:727-717-4389
Mailing Address - Fax:
Practice Address - Street 1:2062 TEMPLE TER
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6674
Practice Address - Country:US
Practice Address - Phone:727-717-4389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014544363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health