Provider Demographics
NPI:1508542937
Name:BROWN, JAMIE NICOLE (MA)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:NICOLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:NICOLE
Other - Last Name:GRIMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:710 LAUREL CT
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7119
Mailing Address - Country:US
Mailing Address - Phone:406-439-4060
Mailing Address - Fax:
Practice Address - Street 1:2006 E PARK AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-5930
Practice Address - Country:US
Practice Address - Phone:501-305-3305
Practice Address - Fax:501-279-0760
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
AR202302235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist