Individual
MRS. JACQUELINE MARIE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,MSN, FNP
Contact information
Practice address
100 KENDALL DR, LAMAR, CO 81052-3901
(716) 366-9154
(719) 336-7453
Mailing address
711 BARNES AVE, LA JUNTA, CO 81050-2138
(716) 384-5446
(719) 384-5672
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
72910
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07729106
—
CO
Enumeration date
03/12/2007
Last updated
09/25/2012
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