Jacqueline Brown, RN

Individual provider Active NPI Registered Nurse · Marinette, WI

NPI 1902201585 · NPPES record last updated Oct 25, 2014

Key facts

NPI
1902201585
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
176877-030 (WI)
Practice address
1203 Jackson St
Marinette, WI 54143-2014
Phone
(715) 587-2423
NPI assigned
Oct 25, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
176877-030WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 176877-030 WI Yes

Addresses

Primary practice location

1203 Jackson St
Marinette, WI 54143-2014

Mailing address

1203 Jackson St
Marinette, WI 54143-2014
Phone (715) 587-2423

Other providers in Marinette, WI

All providers in Marinette, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.