PRISCILLA DENISE BROWN (NPI# 1417508995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417508995 |
Entity Type | Individual |
Full Name | PRISCILLA DENISE BROWN |
Practice Address |
38200 3rd Ave Fort Gordon GA 30905 |
Mailing Address |
3551 Windsor Spring Rd Apt 55 Hephzibah GA 30815-7158 |
Practice Telephone | 6785980022 |
Mailing Telephone | 6785980022 |
Enumeration Date | 2019-09-25 |
Last Update Date | 2019-09-25 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
Address | Telephone Number | Fax Number |
---|---|---|
3551 Windsor Spring Rd Apt 55, Hephzibah, GA 308157158 | 6785980022 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679014534 | Priscilla Beach Brown | Nurse Practitioner | 138 Monte Cresta Ave Apt 206, Oakland, CA 94611-4805 | 2017-03-12 |
1154735769 | Priscilla Brown | Social Worker | 1106 Poplar Place, Rogers, AR 72756-4249 | 2014-06-12 |
1134443989 | Priscilla Ann Brown | Registered Nurse | 435 E Oakwood Blvd Unit 37, Chicago, IL 60653-2337 | 2010-03-23 |
1982883559 | Priscilla Terzo Brown | Speech-Language Pathologist | 169 Ashley Ave, Msc 335, Charleston, SC 29425-8905 | 2007-10-30 |
Street Address |
38200 3RD AVE |
City | FORT GORDON |
State | GA |
Zip Code | 30905 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
1861971335 | Isabella Anderson | Dentist | Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 | 2018-08-07 |
1972097426 | Cortney Wolfley | Student in an Organized Health Care Education/Training Program | Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 | 2018-06-19 |
1003337536 | David Jonathon Sabovich | Dentist | 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 | 2017-07-06 |
1437689411 | Marcos Aranda | Student in an Organized Health Care Education/Training Program | General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2017-06-13 |
1659809846 | Brian Kevin Burke | Student in an Organized Health Care Education/Training Program | 300 East Hosptial Road, Fort Gordon, GA 30905 | 2017-06-01 |
1902334469 | Jacqueline Renee Mulhall | Student in an Organized Health Care Education/Training Program | Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 | 2017-05-30 |
1750837456 | Amanda R Bailey | Internal Medicine | 300 E. Hospital Dr., Fort Gordon, GA 30905 | 2016-09-01 |
1689120016 | Thomas S Moffitt | Internal Medicine | Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2016-08-26 |
1336525344 | Naama Aviv | Dentist | Snyder Dental Clinic, Usadentac, Fort Gordon, GA 30905 | 2015-08-03 |
Find all providers in zip 30905 |
Taxonomy Code | 335E00000X |
Grouping | Suppliers |
Classification | Prosthetic/Orthotic Supplier |
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548860810 | Crowns of Love Inc | Prosthetic/Orthotic Supplier | 707 Park Ave Ne Apt 1382, Atlanta, GA 30326-3410 | 2020-10-27 |
1447860150 | Shadae Renee Medical Wigs | Prosthetic/Orthotic Supplier | 10719 Alpharetta Hwy # 1792, Roswell, GA 30076-2432 | 2020-08-06 |
1114535432 | Beauty Zone2 Medical Wigs | Prosthetic/Orthotic Supplier | 252 Keys Ferry St, Mcdonough, GA 30253-3342 | 2020-07-22 |
1619594389 | Legally Laced | Prosthetic/Orthotic Supplier | 1000 Corporate Pointe Ste 214, Warner Robins, GA 31088-3440 | 2020-06-29 |
1093332009 | Jazzy Wigs, Rx | Prosthetic/Orthotic Supplier | 59 Urey Emerson Dr, Richland, GA 31825-6636 | 2020-06-25 |
1174147938 | Salon Asya Mignon LLC | Prosthetic/Orthotic Supplier | 4290 Memorial Dr Ste B1, Decatur, GA 30032-1225 | 2020-06-07 |
1023630928 | Michelles Beauty Bar | Prosthetic/Orthotic Supplier | 3662 Druid Oaks Dr, Valdosta, GA 31605-6542 | 2020-05-13 |
1366063596 | Stylish Styles By Tee | Prosthetic/Orthotic Supplier | 6595 Roswell Rd Ste G1169, Atlanta, GA 30328-3152 | 2020-04-28 |
1518503432 | Regina Murff-love | Prosthetic/Orthotic Supplier | 341 Indus Ln, Lawrenceville, GA 30044-3835 | 2019-11-26 |
1811545650 | Salon Bar LLC | Prosthetic/Orthotic Supplier | 4705 Ashford Dunwoody Rd # 4, Dunwoody, GA 30338-5566 | 2019-08-26 |
Find all providers with the same taxonomy |
City | FORT GORDON |
Zip Code | 30905 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.