Provider Demographics
NPI:1194554584
Name:BROWN, CYNTHIA BROOKE
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:BROOKE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 FOREST LAKES DR
Mailing Address - Street 2:
Mailing Address - City:STERRETT
Mailing Address - State:AL
Mailing Address - Zip Code:35147-8191
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3690 GRANDVIEW PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3326
Practice Address - Country:US
Practice Address - Phone:205-971-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2024030013363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner