Provider Demographics
NPI:1700359072
Name:BROWN, SHARONDA CHERI (FNP)
Entity Type:Individual
Prefix:
First Name:SHARONDA
Middle Name:CHERI
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 VIRGINIA AVE S
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-8073
Mailing Address - Country:US
Mailing Address - Phone:229-234-2916
Mailing Address - Fax:
Practice Address - Street 1:2704 N OAK ST BLDG J
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1768
Practice Address - Country:US
Practice Address - Phone:229-262-7333
Practice Address - Fax:229-262-7335
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN248586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily