Provider Demographics
NPI:1568440303
Name:BROWNING, JACQUELYN (GNP)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:
Last Name:BROWNING
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 CREEKBEND LN
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9412
Mailing Address - Country:US
Mailing Address - Phone:585-645-5518
Mailing Address - Fax:
Practice Address - Street 1:300 MERIDIAN CENTRE
Practice Address - Street 2:SUITE 320 EVERCARE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-645-5518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3403681363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P25912Medicare UPIN