Provider Demographics
NPI:1255765889
Name:BROWN, JEANNETTE GLORIA (WHNP BC MSN)
Entity type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:GLORIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:WHNP BC MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12504 HILLGATE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-2420
Mailing Address - Country:US
Mailing Address - Phone:804-740-6699
Mailing Address - Fax:
Practice Address - Street 1:9000 STONY POINT PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1900
Practice Address - Country:US
Practice Address - Phone:804-327-8820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017141142363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health