Provider Demographics
NPI:1104503093
Name:BROWN, STANASIA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:STANASIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 PEACHTREE PKWY STE 240-156
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-3336
Mailing Address - Country:US
Mailing Address - Phone:404-805-1849
Mailing Address - Fax:
Practice Address - Street 1:6050 PEACHTREE PKWY STE 240-156
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-3336
Practice Address - Country:US
Practice Address - Phone:404-805-1849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN245619363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health