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Individual

JEAN R BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1201 NOTT STREET, SUITE 307, SCHENECTADY, NY 12308-2589
(518) 243-3388
(518) 243-1329
Mailing address
1201 NOTT STREET, SUITE 307, SCHENECTADY, NY 12308-2589
(518) 243-3388
(518) 243-1329

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
300222
NY
363LF0000X
Family Nurse Practitioner
331304
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000692111
GHI HMO
NY
01
000494228001
BLUE SHIELD
NY
05
00347562
NY
01
040426006783
FIDELIS
NY
01
11464152
CAQH
01
318476
MVP
NY
01
500015186
RR MEDICARE
NY
01
7599230
PPOGHI
NY
Enumeration date
01/25/2006
Last updated
03/05/2009
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