=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871353391
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAZMINE KATRICE BROWN APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2024
-----------------------------------------------------
Last Update Date | 09/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1278 N LAFAYETTE DR
-----------------------------------------------------
City | SUMTER
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29150-2964
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-774-4500
-----------------------------------------------------
Fax | 803-774-4650
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 521 HARBOUR POINTE DR
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29229-7476
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-448-9988
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 28511
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------