Provider Demographics
NPI:1669025854
Name:BURKES-BROWN, CHELESIA (PMHNP)
Entity Type:Individual
Prefix:
First Name:CHELESIA
Middle Name:
Last Name:BURKES-BROWN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 HEALTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2054
Mailing Address - Country:US
Mailing Address - Phone:334-702-7222
Mailing Address - Fax:334-446-4224
Practice Address - Street 1:408 HEALTHWEST DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303
Practice Address - Country:US
Practice Address - Phone:334-702-7222
Practice Address - Fax:334-446-4224
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014946363LP0808X
AL1-141028363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health