Provider Demographics
NPI:1063648103
Name:BROWN, JESSICA D (RN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 WEBER BLDG. HWY 62 NW
Mailing Address - Street 2:HARRISON CO. MATERNAL & CHILD
Mailing Address - City:CORYDON
Mailing Address - State:IN
Mailing Address - Zip Code:47112-1924
Mailing Address - Country:US
Mailing Address - Phone:812-738-1600
Mailing Address - Fax:812-738-6473
Practice Address - Street 1:1070 WEBER BLDG. HWY 62 NW
Practice Address - Street 2:HARRISON CO. MATERNAL & CHILD
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-1924
Practice Address - Country:US
Practice Address - Phone:812-738-1600
Practice Address - Fax:812-738-6473
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28077680A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200091610Medicaid