Basic Information
Provider Information
NPI: 1083172084
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: ANNA
MiddleName: LEE
NamePrefix:  
NameSuffix:  
Credential: MSN, WHNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: AKERS
OtherFirstName: ANNA
OtherMiddleName: LEE
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1802 6TH AVE S
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352331932
CountryCode: US
TelephoneNumber: 2059343411
FaxNumber:  
Practice Location
Address1: 1802 6TH AVE S
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352331932
CountryCode: US
TelephoneNumber: 2059343411
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/08/2019
LastUpdateDate: 03/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102X1-149217ALY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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