Jacqueline Brown, CRNP

Individual provider Active NPI Primary Care Nurse Practitioner · Drexel Hill, PA

NPI 1922425362 · NPPES record last updated Mar 24, 2014

Key facts

NPI
1922425362
Entity type
Individual (NPI type 1)
Primary specialty
Primary Care Nurse Practitioner 363LP2300X
License
SP013553 (PA)
Practice address
529 Penn Ave
Drexel Hill, PA 19026-1414
Phone
(215) 870-4632
NPI assigned
Mar 24, 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)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X SP013553 PA Yes

Addresses

Primary practice location

529 Penn Ave
Drexel Hill, PA 19026-1414

Mailing address

529 Penn Ave
Drexel Hill, PA 19026-1414
Phone (215) 870-4632

Other providers in Drexel Hill, PA

All providers in Drexel Hill, PA · Primary Care Nurse Practitioner in Pennsylvania

Sources for this page

Verify at the official NPI Registry.