MEDICARE: JASMINE DASHAWN BROWN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	PN5256025	FL

General Provider Information

NPI Number	:	1891566139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE DASHAWN BROWN

Provider Business Mailing Address
First Line	:	PO BOX 65001
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32065-0001
Country	:	US
Telephone Number	:	803-613-9141
Fax Number	:

Provider Business Practice Location Address
First Line	:	6625 ARGYLE FOREST BLVD STE 4
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-6126
Country	:	US
Telephone Number	:	803-849-9803
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2024
Last Update Date	:	04/26/2024

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