Provider Demographics
NPI:1356383509
Name:BROWN, SANDRA MICHELLE (CRNP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18428
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-8428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3601 CCI DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-2606
Practice Address - Country:US
Practice Address - Phone:256-705-4224
Practice Address - Fax:256-705-4135
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1092970363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP00355209OtherRR MEDICARE NUMBER
AL111642Medicaid
AL515-45152OtherBCBS OF ALABAMA
AL528701110Medicaid
AL515-36502OtherBCBS OF ALABAMA
ALCA0084OtherRR MEDICARE
AL515-45152OtherBCBS OF ALABAMA
ALCA0084OtherRR MEDICARE
AL515-36502OtherBCBS OF ALABAMA
051539692OtherBLUE CROSS OF ALABAMA
051557876Medicare PIN
051539692OtherBLUE CROSS OF ALABAMA
AL515-95506OtherBCBS OF ALABAMA