Provider Demographics
NPI:1508288911
Name:BROWN, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:I
Other - Last Name:ROBINSON( MAIDEN) DEHANEY LPN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RB
Mailing Address - Street 1:215 BRIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3705
Mailing Address - Country:US
Mailing Address - Phone:585-746-3525
Mailing Address - Fax:
Practice Address - Street 1:215 BRIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3705
Practice Address - Country:US
Practice Address - Phone:585-746-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY586357-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse