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General NPI Number Information
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NPI Number | 1487247870
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Entity Type | Individual
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Provider Name | JENNA NATEAL BROWN-KIRK RN
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Gender | Female
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 18 E BEECH ST
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4134
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Country | US
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Telephone | 928-634-0391
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Fax |
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Provider Business Mailing Address
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Address Line | 3207 HACIENDA DR
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City | DUARTE
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State | CA
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Zip | 91010-2314
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Country | US
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Telephone | 707-339-0299
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 255031
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WP1700X
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Taxonomy Name | Perinatal Registered Nurse
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License Number | 95057811
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License Number State | CA
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