Provider Demographics
NPI:1134647027
Name:JACOBI BROWN, ANN (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:JACOBI BROWN
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:JACOBI
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10 ALSTON DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-3100
Mailing Address - Country:US
Mailing Address - Phone:919-929-0340
Mailing Address - Fax:
Practice Address - Street 1:500 CAROLINA MDWS
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8471
Practice Address - Country:US
Practice Address - Phone:919-370-7102
Practice Address - Fax:919-942-0377
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC254213363LG0600X, 363LA2200X, 363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care