MEDICARE: JERILYN BROWN APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	194892	CO
2	363L00000X	Nurse Practitioner	3008880	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	K180423	OTHER	KY	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528089125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERILYN BROWN APRN

Provider Business Mailing Address
First Line	:	10101 LINN STATION RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-3848
Country	:	US
Telephone Number	:	502-589-5860
Fax Number	:

Provider Business Practice Location Address
First Line	:	2105 CRUMS LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40216-4231
Country	:	US
Telephone Number	:	502-589-8915
Fax Number	:	502-449-1259

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	03/19/2025

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Directions to “ JERILYN BROWN APRN” Practice Location

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