Healthcare Provider Details

I. General information

NPI: 1356017008
Provider Name (Legal Business Name): JACQUELYNN LORENA BROWNING APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2021
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAVALE MEDICAL CENTER 922 NATIONAL HIGHWAY
LAVALE MD
21502
US

IV. Provider business mailing address

262 GLENVIEW LN
KEYSER WV
26726-6743
US

V. Phone/Fax

Practice location:
  • Phone: 240-362-7294
  • Fax:
Mailing address:
  • Phone: 304-790-2248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC003843
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: