Provider Demographics
NPI:1669981742
Name:BROWN, JENNIFER POINEAU (CNM)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:POINEAU
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7985 S MACKINAW TRL
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-8111
Mailing Address - Country:US
Mailing Address - Phone:231-876-6100
Mailing Address - Fax:231-779-5290
Practice Address - Street 1:7985 S MACKINAW TRL
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-8111
Practice Address - Country:US
Practice Address - Phone:231-876-6100
Practice Address - Fax:231-779-5290
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704221136176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Single Specialty