Provider Demographics
NPI:1104804723
Name:BROWN, JO ANN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:JO ANN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:JO
Other - Middle Name:ANN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN CNP 05359
Mailing Address - Street 1:329 HEIDI CT
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-7318
Mailing Address - Country:US
Mailing Address - Phone:513-317-2811
Mailing Address - Fax:
Practice Address - Street 1:329 HEIDI CT
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-7318
Practice Address - Country:US
Practice Address - Phone:513-317-2811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.05359363LF0000X
OHNP-05359363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2253627Medicaid
OHBRNP20092Medicare PIN
OH2253627Medicaid