Healthcare Provider Details

I. General information

NPI: 1972052918
Provider Name (Legal Business Name): JORDAN F. BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2016
Last Update Date: 10/03/2016
Certification Date: BROWN JORDAN F. PO BOX 1213 BRUNSWICK GA 31521 2500 STARLING ST STE 506 BRUNSWICK GA 31520
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 STARLING ST STE 506
BRUNSWICK GA
31520-4270
US

IV. Provider business mailing address

PO BOX 1213
BRUNSWICK GA
31521-1213
US

V. Phone/Fax

Practice location:
  • Phone: 912-466-5506
  • Fax: 912-466-5513
Mailing address:
  • Phone: 912-466-5083
  • Fax: 912-466-5013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN223588
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: