Jacqueline Ann Brown, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN194174 Issued in GA

Practice address

122 Canal St Ste 102
Pooler, GA 31322-4408

Phone

(912) 450-0999

Fax

(912) 450-0998

NPI assigned

Dec 7, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Parkway Family Medicine LLC

  • Primary Care Clinic/Center
  • Pooler, GA
  • NPI 1730486598

  GA

  Medicare reassignment NPD
• Premier Weight Loss Management

  • Obesity Medicine (Preventive Medicine) Physician
  • Pooler, GA
  • NPI 1417632175
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1942578737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 CANAL ST STE 102",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224408",
            "telephone_number": "912-450-0999",
            "fax_number": "912-450-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 CANAL ST STE 102",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224408",
            "telephone_number": "912-450-0999",
            "fax_number": "912-450-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "194174",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN194174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Camille Brinson, RBT
• Alexandria Copeland Brooks, MSN, APRN, FNP-BC
• Faberge Brooks
• Arreyona Amea Rana Brown
• Donna Marie Brown
• Jennifer Brown
• Lauren Ashley Brown
• Ludella Brown, APRN NP-C
• Michelle Brown, BCBA
• Morgan Larissa Brown

• All providers in Pooler, GA
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.