Provider Demographics
NPI:1932974573
Name:BROWN, CHARNETTE PATRICE (LPN)
Entity Type:Individual
Prefix:
First Name:CHARNETTE
Middle Name:PATRICE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2884
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30091-2884
Mailing Address - Country:US
Mailing Address - Phone:404-707-0590
Mailing Address - Fax:
Practice Address - Street 1:3550 PLEASANT HILL RD APT 214
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4871
Practice Address - Country:US
Practice Address - Phone:404-707-0590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN094745164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse