Provider Demographics
NPI:1144846767
Name:CROSS-BROWN, AVANTI (RN, APRN, PMHNP, DNP)
Entity type:Individual
Prefix:DR
First Name:AVANTI
Middle Name:
Last Name:CROSS-BROWN
Suffix:
Gender:F
Credentials:RN, APRN, PMHNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 TENNESSEE ST
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:TN
Mailing Address - Zip Code:38008-2441
Mailing Address - Country:US
Mailing Address - Phone:901-864-9563
Mailing Address - Fax:901-425-9773
Practice Address - Street 1:793 TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:TN
Practice Address - Zip Code:38008-2441
Practice Address - Country:US
Practice Address - Phone:901-864-9563
Practice Address - Fax:901-425-9773
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29813363LP0808X, 363LP0808X
TN210549163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS905993OtherAPRN
TN29813OtherAPRN