Healthcare Provider Details

I. General information

NPI: 1639034853
Provider Name (Legal Business Name): JORDAN THERESE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 MAIN ST STE 330
NASHUA NH
03060-2920
US

IV. Provider business mailing address

23 BEACON ST
WESTFORD MA
01886-2127
US

V. Phone/Fax

Practice location:
  • Phone: 603-578-7411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number080660-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: