| Doctor Name: | MRS. TISHA MICHELLE BROWN |
| NPI Number: | 1104265826 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, FNP-C |
| License Number: | 18316 |
| Business Practice Address: | 1010 Highway 17 N North Myrtle Beach, SC - 295822806 |
| Business Phone Number: | 8663892727 |
| Business Fax Number: | |
| Mailing Address: | 3531 Rogers Rd, LORIS |
| State: | SC |
| Postal Code: | 295693215 |
| Phone Number: | 8435049946 |
| Fax Number: | 8437569333 |
| NPI Enumeration Date: | 06/15/2013 |
| NPI Last Update Date: | 06/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 18316 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |