Provider Demographics
NPI:1710222450
Name:BROWN, CYNTHIA M (APRN)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:BROWN.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN,CNSPMH, ANP
Mailing Address - Street 1:2212 OAKGROVE CIR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2203
Mailing Address - Country:US
Mailing Address - Phone:229-244-4142
Mailing Address - Fax:
Practice Address - Street 1:34 PEACHTREE ST., N.W.
Practice Address - Street 2:SUITE 77 MHM,
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303
Practice Address - Country:US
Practice Address - Phone:800-729-1601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN038371163WP0809X, 363LA2200X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult