Provider Demographics
NPI:1588029482
Name:BROWN, JENNIFER VALERIE (RN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:VALERIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HARPST ST
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-8222
Mailing Address - Country:US
Mailing Address - Phone:707-826-3146
Mailing Address - Fax:707-826-5042
Practice Address - Street 1:1 HARPST ST
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-8222
Practice Address - Country:US
Practice Address - Phone:707-826-3146
Practice Address - Fax:707-826-5042
Is Sole Proprietor?:No
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA391643163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse