Basic Information
Provider Information
NPI: 1982190237
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWNER
FirstName: SHAMEKIA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: AGACNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2591 AMELIA AVE
Address2:  
City: DECATUR
State: GA
PostalCode: 300323214
CountryCode: US
TelephoneNumber: 7045331595
FaxNumber:  
Practice Location
Address1: 1364 CLIFTON RD NE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303221059
CountryCode: US
TelephoneNumber: 4047785334
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/10/2018
LastUpdateDate: 07/10/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100XRN232971GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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