Provider Demographics
NPI:1831882745
Name:BROWN, SHANE NOLAN (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:NOLAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-6122
Mailing Address - Country:US
Mailing Address - Phone:828-695-5900
Mailing Address - Fax:828-695-4256
Practice Address - Street 1:327 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-6122
Practice Address - Country:US
Practice Address - Phone:828-695-5900
Practice Address - Fax:828-695-4256
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018555363LF0000X
NCBROW-AEKKW363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily