Provider Demographics
NPI:1174277909
Name:BROWN, JASMYNE RENEE' (ND)
Entity Type:Individual
Prefix:
First Name:JASMYNE
Middle Name:RENEE'
Last Name:BROWN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:JASMYNE
Other - Middle Name:R
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JASMYNE HAWTHORNE ND
Mailing Address - Street 1:1406 BRISTOL DR
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-8644
Mailing Address - Country:US
Mailing Address - Phone:816-827-1134
Mailing Address - Fax:
Practice Address - Street 1:1406 BRISTOL DR
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-8644
Practice Address - Country:US
Practice Address - Phone:816-827-1134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS21-00059175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath