Jacqueline Brown
Individual provider Active NPI Family Nurse Practitioner · West Lafayette, IN
NPI 1831625672 · NPPES record last updated May 11, 2017
Key facts
- NPI
- 1831625672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 28170225A (IN)
- Practice address
- 601 Stadium Mall Dr
West Lafayette, IN 47907-2052 - Phone
- (765) 494-1700
- NPI assigned
- May 11, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28170225A | IN | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 28170225A | IN | Yes |
Addresses
Primary practice location
601 Stadium Mall Dr
West Lafayette, IN 47907-2052
Mailing address
601 Stadium Mall Dr
West Lafayette, IN 47907-2052
Other providers in West Lafayette, IN
- Alyssa Broshar
- Brooklynn Brouhard
- Barbara L Brown
- Caitlin Ann Brown
- Elizabeth Ann Brown
- Lisa M Brown
- Victoria Brown
- Zion Brown
- Alyssa Louise Browning
- Jennifer Brumley
All providers in West Lafayette, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.