Provider Demographics
NPI:1194046870
Name:BROWN, MELODY DEMPSEY (RN)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:DEMPSEY
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 OAK ISLAND ESTATES RD
Mailing Address - Street 2:
Mailing Address - City:JESUP
Mailing Address - State:GA
Mailing Address - Zip Code:31545-8043
Mailing Address - Country:US
Mailing Address - Phone:478-308-0549
Mailing Address - Fax:
Practice Address - Street 1:491 OAK ISLAND ESTATES RD
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:GA
Practice Address - Zip Code:31545-8043
Practice Address - Country:US
Practice Address - Phone:912-287-0301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA102714163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse