JACKQULYN BROWN NPI 1194591719

NPI Information

  • NPI: 1194591719
  • Provider Name: JACKQULYN BROWN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 20755 GREENFIELD RD STE 100
    SOUTHFIELD, MI
    ZIP 48075
  • Phone: (248) 557-0507

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NPI Details

Jackqulyn Brown is a family nurse practitioner in Southfield, MI. Jackqulyn Brown NPI is 1194591719. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

20755 GREENFIELD RD STE 100
SOUTHFIELD, MI
ZIP 48075-400
Phone: (248) 557-0507

The enumeration date for this NPI number is 11/27/2023 and was last updated on 11/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse4704342245MICHIGANNo
2363LF0000XNurse PractitionerFamily4704342245MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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