Provider Demographics
NPI:1104804723
Name:BROWN, JO ANN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:JO
Middle Name:ANN
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 1:601 S EDWIN C. MOSES BLVD
Mailing Address - Street 2:SAMARITAN BEHAVIORAL HEALTH, INC.
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3424
Mailing Address - Country:US
Mailing Address - Phone:937-734-8333
Mailing Address - Fax:937-734-4343
Practice Address - Street 1:601 EDWIN C MOSES BLVD.
Practice Address - Street 2:SAMARITAN BEHAVIORAL HEALTH, INC.
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3424
Practice Address - Country:US
Practice Address - Phone:937-734-8333
Practice Address - Fax:937-734-4343
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-04-13
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