Individual
MARY JACQUELYN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
901 LEIGHTON AVE, SUITE 101, ANNISTON, AL 36207-5700
(256) 236-0890
Mailing address
PO BOX 276, ANNISTON, AL 36202-0276
(256) 236-0890
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1-046804
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51539906
BLUECROSS
AL
Enumeration date
06/08/2006
Last updated
07/09/2007
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