Provider Demographics
NPI:1548777188
Name:T. JAREL BROWN APRN CNP PLLC
Entity Type:Organization
Organization Name:T. JAREL BROWN APRN CNP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:TABETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-649-0069
Mailing Address - Street 1:210 WEST ROBERT ST
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-2942
Mailing Address - Country:US
Mailing Address - Phone:918-658-8021
Mailing Address - Fax:918-647-2288
Practice Address - Street 1:210 WEST ROBERT ST
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-2942
Practice Address - Country:US
Practice Address - Phone:918-649-0066
Practice Address - Fax:918-649-0067
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:T. JAREL BROWN APRN CNP PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-04
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0100665261QH0100X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Single Specialty