Provider Demographics
NPI:1861460776
Name:BROWN, JENNIFER COLLEEN (CNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:COLLEEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:COLLEEN
Other - Last Name:BARNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:881 COMMONWEALTH AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1300
Mailing Address - Country:US
Mailing Address - Phone:617-353-3575
Mailing Address - Fax:617-353-3557
Practice Address - Street 1:881 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1390
Practice Address - Country:US
Practice Address - Phone:617-353-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209005187363LF0000X
MARN2316421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily