Provider Demographics
NPI:1821171760
Name:BROWN, JESSICA LYN (DO MPH)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LYN
Last Name:BROWN
Suffix:
Gender:F
Credentials:DO MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-526-0001
Mailing Address - Fax:
Practice Address - Street 1:8200 CONSTANTIN BLVD FL 3
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3481
Practice Address - Country:US
Practice Address - Phone:225-765-5500
Practice Address - Fax:225-765-1899
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3013312080P0214X
ALDO.1267207P00000X
ALDO. 1267208000000X
OK4725208000000X
FLOS 10087208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-38604OtherBCBS
AL150971Medicaid
AL511-38601OtherBCBS
AL151077Medicaid
AL137467Medicaid
AL138473Medicaid