Provider Demographics
NPI:1750754339
Name:BROWN, JENIFER (RTRM)
Entity type:Individual
Prefix:MRS
First Name:JENIFER
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:RTRM
Other - Prefix:MISS
Other - First Name:JENIFER
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RTRM
Mailing Address - Street 1:4665 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-7636
Mailing Address - Country:US
Mailing Address - Phone:704-642-1335
Mailing Address - Fax:
Practice Address - Street 1:4665 MILLER RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-7636
Practice Address - Country:US
Practice Address - Phone:704-642-1335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M2300XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMammography
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography