Provider Demographics
NPI:1952786766
Name:BROWN, JESSICA K
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:K
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W MERCHANT ST APT 1
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-2332
Mailing Address - Country:US
Mailing Address - Phone:856-263-0786
Mailing Address - Fax:
Practice Address - Street 1:200 W MERCHANT ST APT 1
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-2332
Practice Address - Country:US
Practice Address - Phone:856-263-0786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist