Provider Demographics
NPI:1215191549
Name:BROWN, JENNY (CPA)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:CPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 WAKEFIELD PINES DR STE 115
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-7078
Mailing Address - Country:US
Mailing Address - Phone:919-488-0111
Mailing Address - Fax:919-488-0104
Practice Address - Street 1:2810 WAKEFIELD PINES DR STE 115
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-7078
Practice Address - Country:US
Practice Address - Phone:919-488-0111
Practice Address - Fax:919-488-0104
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01408363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical