Provider Demographics
NPI:1497460166
Name:BROWN, JAMIE A
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 34TH ST SE APT 130834TH
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-8253
Mailing Address - Country:US
Mailing Address - Phone:202-910-5011
Mailing Address - Fax:
Practice Address - Street 1:215 BROADUS ST
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-1384
Practice Address - Country:US
Practice Address - Phone:187-765-9450
Practice Address - Fax:888-972-3891
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth