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General NPI Number Information
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NPI Number | 1669441226
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Entity Type | Individual
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Provider Name | JENNIFER ANN BROWN ATC
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Gender | Female
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 3719 TERRACE STREET ROOM 2152
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City | PITTSBURGH
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State | PA
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Zip | 15261-1701
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Country | US
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Telephone | 412-648-4299
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Fax |
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Provider Business Mailing Address
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Address Line | 3226 PRIMROSE LN
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City | YPSILANTI
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State | MI
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Zip | 48197-3215
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Country | US
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Telephone | 847-942-4291
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2601001420
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 096-001914
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RTO000409
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License Number State | PA
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