Healthcare Provider Details

I. General information

NPI: 1851984595
Provider Name (Legal Business Name): JENNA MARIE BROWN APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2021
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

584 LEWISVILLE RD
WOODSFIELD OH
43793-3504
US

IV. Provider business mailing address

101 E MAIN ST
BARNESVILLE OH
43713-1005
US

V. Phone/Fax

Practice location:
  • Phone: 740-239-6447
  • Fax:
Mailing address:
  • Phone: 740-239-6447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0028420
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.420355
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: