Provider Demographics
NPI:1043290638
Name:BROWN, JANET (APRN)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
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 1:205 W 14TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1114
Mailing Address - Country:US
Mailing Address - Phone:302-421-2100
Mailing Address - Fax:
Practice Address - Street 1:205 W 14TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1114
Practice Address - Country:US
Practice Address - Phone:302-421-2100
Practice Address - Fax:302-421-2121
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELE0000128363LP0808X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE009844C60Medicare PIN
DEP36883Medicare UPIN