Healthcare Provider Details

I. General information

NPI: 1871353391
Provider Name (Legal Business Name): JAZMINE KATRICE BROWN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1278 N LAFAYETTE DR
SUMTER SC
29150-2964
US

IV. Provider business mailing address

521 HARBOUR POINTE DR
COLUMBIA SC
29229-7476
US

V. Phone/Fax

Practice location:
  • Phone: 803-774-4500
  • Fax: 803-774-4650
Mailing address:
  • Phone: 864-448-9988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number28511
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: