Provider Demographics
NPI:1801842075
Name:BROWN, JENNIFER R (OT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:BROWN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 W 6TH ST
Mailing Address - Street 2:STE 120
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2215
Mailing Address - Country:US
Mailing Address - Phone:785-749-1300
Mailing Address - Fax:785-749-4746
Practice Address - Street 1:400 N 18TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-4208
Practice Address - Country:US
Practice Address - Phone:913-321-8765
Practice Address - Fax:913-321-8765
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2220225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS35401015OtherBCBS KC
KS013988OtherBCBS KS
KS35401015OtherPHP
KS176538OtherFIRSTGUARD
KS5548578OtherAETNA
KS35401015OtherPHP