Provider Demographics
NPI:1891930269
Name:BROWN, MICHAEL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4168 OUTER DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-4245
Mailing Address - Country:US
Mailing Address - Phone:305-608-7829
Mailing Address - Fax:
Practice Address - Street 1:2515 PARK PLZ BLDG 2
Practice Address - Street 2:HCA WELLNESS CENTER
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1512
Practice Address - Country:US
Practice Address - Phone:615-344-2500
Practice Address - Fax:615-344-2410
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13689363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1517875Medicaid
TN103I507413Medicare PIN
TN3342454Medicare PIN
TN103I508394Medicare PIN
TN103I503727Medicare PIN
TN103I503572Medicare PIN
TN103I506573Medicare PIN
TN1517875Medicaid