Provider Demographics
NPI:1649252628
Name:BROWN, CYNTHIA V (ANP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:V
Last Name:BROWN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 HOLCOMB BRIDGE ROAD
Mailing Address - Street 2:SUITE 129
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076
Mailing Address - Country:US
Mailing Address - Phone:678-325-2250
Mailing Address - Fax:
Practice Address - Street 1:1475 HOLCOMB BRIDGE RD
Practice Address - Street 2:SUITE 129
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-2139
Practice Address - Country:US
Practice Address - Phone:678-325-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN028296 NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
S59978Medicare UPIN
50BBJQDMedicare ID - Type Unspecified