Basic Information
| Provider Information | |||||||||
| NPI: | 1851984595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | JENNA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | APRN-CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BARNESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437131005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402396447 | ||||||||
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| Practice Location | |||||||||
| Address1: | 584 LEWISVILLE RD | ||||||||
| Address2: | |||||||||
| City: | WOODSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437933504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402396447 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2021 | ||||||||
| LastUpdateDate: | 01/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN.420355 | OH | N | Nursing Service Providers | Registered Nurse | 363L00000X | APRN.CNP.0028420 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.