Provider Demographics
NPI:1548659675
Name:BROWN, JENNIFER ANN (APRN)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4045 NE LAKEWOOD WAY STE 130
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-1995
Mailing Address - Country:US
Mailing Address - Phone:816-886-2184
Mailing Address - Fax:816-886-2397
Practice Address - Street 1:4045 NE LAKEWOOD WAY STE 130
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-1995
Practice Address - Country:US
Practice Address - Phone:816-886-2184
Practice Address - Fax:816-886-2397
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-13
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76654-011363LP0808X
MO2015002657363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health