Provider Demographics
NPI:1831811058
Name:BROWN, RYAN (APRN, DNP-PNP, CPNP)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:APRN, DNP-PNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2446 YOUNG DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-3026
Mailing Address - Country:US
Mailing Address - Phone:706-993-8303
Mailing Address - Fax:
Practice Address - Street 1:1447 HARPER STREET MEDICAL OFFICE BUILDING - 3RD FLOOR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-0001
Practice Address - Country:US
Practice Address - Phone:706-721-4929
Practice Address - Fax:706-721-4575
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN246900363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics