Healthcare Provider Details

I. General information

NPI: 1679140982
Provider Name (Legal Business Name): JASMINE ELAINE BROWN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2021
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 ELKRIDGE RD
LINTHICUM MD
21090
US

IV. Provider business mailing address

12045 ABBERLY PL APT 108
WALDORF MD
20601-2717
US

V. Phone/Fax

Practice location:
  • Phone: 240-349-3108
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberC0010441
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: