Provider Demographics
NPI:1730514506
Name:BROWN, JESSICA ANN (FNP-BC, APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 PALM COAST PKWY SW UNIT 303
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-4776
Mailing Address - Country:US
Mailing Address - Phone:386-447-7337
Mailing Address - Fax:
Practice Address - Street 1:397 PALM COAST PKWY SW UNIT 303
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-4776
Practice Address - Country:US
Practice Address - Phone:386-447-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008272363LF0000X
WV87104363LF0000X
FL9346594363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012963300Medicaid