Provider Demographics
NPI:1376948356
Name:BROWN, JORDYN (MS)
Entity Type:Individual
Prefix:
First Name:JORDYN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WALLACE ST S
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:ND
Mailing Address - Zip Code:58722-2235
Mailing Address - Country:US
Mailing Address - Phone:701-839-7135
Mailing Address - Fax:866-666-9789
Practice Address - Street 1:315 MAIN ST S
Practice Address - Street 2:SUITE 104
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3956
Practice Address - Country:US
Practice Address - Phone:701-837-9801
Practice Address - Fax:866-666-9789
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1358235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist