| Doctor Name: | WANDA BROWN |
| NPI Number: | 1083071237 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | WHNP |
| License Number: | 901414 |
| Business Practice Address: | 401 Southcrest Cir Suite 105 Southaven, MS - 386716726 |
| Business Phone Number: | 6623494322 |
| Business Fax Number: | 6623496364 |
| Mailing Address: | P O Box 1000, Dept 978 MEMPHIS |
| State: | TN |
| Postal Code: | 381040978 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/19/2016 |
| NPI Last Update Date: | 01/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 901414 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |