Glory Jean Logan-Brown

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

RN102065 Issued in GA

Practice address

637 Fallview Dr
Forest Park, GA 30297-3020

Phone

(770) 580-9242

NPI assigned

Feb 27, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1326632522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 FALLVIEW DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973020",
            "telephone_number": "770-580-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 FALLVIEW DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973020",
            "telephone_number": "770-580-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN-BROWN",
        "first_name": "GLORY",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-27",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "GA",
            "license": "RN102065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Registered Nurse in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Case Management Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.