Healthcare Provider Details

I. General information

NPI: 1043700644
Provider Name (Legal Business Name): JORDAN ASHLEY BROWNING ANYANWU D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JORDAN ASHLEY BROWNING D.O.

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4881 SUGAR MAPLE DR
WRIGHT PAT OH
45433-5529
US

IV. Provider business mailing address

4881 SUGAR MAPLE DR
WRIGHT PAT OH
45433-5529
US

V. Phone/Fax

Practice location:
  • Phone: 228-376-0425
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number34.014732
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number0152160
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: