Provider Demographics
NPI:1912528035
Name:BROWN, DESHAUN INGERSOLL (ND)
Entity Type:Individual
Prefix:
First Name:DESHAUN
Middle Name:INGERSOLL
Last Name:BROWN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6470 COVE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-3400
Mailing Address - Country:US
Mailing Address - Phone:225-500-2927
Mailing Address - Fax:706-671-6317
Practice Address - Street 1:6470 COVE CREEK CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3400
Practice Address - Country:US
Practice Address - Phone:706-773-1397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator