Provider Demographics
NPI:1851984595
Name:BROWN, JENNA MARIE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43713-1005
Mailing Address - Country:US
Mailing Address - Phone:740-239-6447
Mailing Address - Fax:
Practice Address - Street 1:584 LEWISVILLE RD
Practice Address - Street 2:
Practice Address - City:WOODSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43793-3504
Practice Address - Country:US
Practice Address - Phone:740-239-6447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-13
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.420355163W00000X
OHAPRN.CNP.0028420363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse