Provider Demographics
NPI:1871931733
Name:BROWN, EMILY JOY JENSEN (PA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JOY JENSEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JOY
Other - Last Name:JENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1968 PEACHTREE RD NW
Mailing Address - Street 2:BUILDING 77, 6TH FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1281
Mailing Address - Country:US
Mailing Address - Phone:404-605-2905
Mailing Address - Fax:678-244-6608
Practice Address - Street 1:1968 PEACHTREE RD NW
Practice Address - Street 2:BUILDING 77, 6TH FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1281
Practice Address - Country:US
Practice Address - Phone:404-605-2905
Practice Address - Fax:678-244-6608
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005693363A00000X
GA6864363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant