Provider Demographics
NPI:1801656129
Name:MARBURY BROWN, ANGELICA M (FNP)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:M
Last Name:MARBURY 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 1:121 GLEN CROSS CIR
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-0015
Mailing Address - Country:US
Mailing Address - Phone:205-396-7483
Mailing Address - Fax:
Practice Address - Street 1:601 BEACON PKWY W STE 212
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3123
Practice Address - Country:US
Practice Address - Phone:205-666-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-152276363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner