Charon Brown
Individual provider Active NPI Licensed Practical Nurse · Monroe, GA
NPI 1659944122 · NPPES record last updated Jul 21, 2021
Key facts
- NPI
- 1659944122
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 099785 (GA)
- Practice address
- 503 Heritage Ridge Dr
Monroe, GA 30655-8438 - Phone
- (470) 314-2586
- NPI assigned
- Jul 21, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 099785 | GA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 099785 | GA | Yes |
Addresses
Primary practice location
503 Heritage Ridge Dr
Monroe, GA 30655-8438
Mailing address
503 Heritage Ridge Dr
Monroe, GA 30655-8438
Phone (470) 314-2586
Other providers in Monroe, GA
- Sharon Malone Bowden
- Christina Bradford
- Kate Ann Breiner
- Catilin Briscoe
- Steven Broadway
- Lawrence Michael Bruner Jr.
- Melissa Jones Bupp
- Sha'Teira Keyaji Burnett
- Diondra Trenee' Burney Atoyebi
- Courtney Summer Burrell
All providers in Monroe, GA · Licensed Practical Nurse in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.