Healthcare Provider Details

I. General information

NPI: 1447752837
Provider Name (Legal Business Name): JENNIFER NICOLE BROWN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8094 BEECHMONT AVE
CINCINNATI OH
45255
US

IV. Provider business mailing address

8094 BEECHMONT AVE
CINCINNATI OH
45255-3145
US

V. Phone/Fax

Practice location:
  • Phone: 513-232-7100
  • Fax: 513-232-6975
Mailing address:
  • Phone: 513-232-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022491
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: