Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1-131330 | AL |
NPI | 1033659917 |
---|---|
Provider Name | Jason Michael Brown |
First Address | Birmingham, AL 35255-2310 |
Second Address | Birmingham, AL 35233-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2017 |
Last Update Date | 12/06/2017 |