Provider Demographics
NPI:1285373852
Name:MILES-BROWN, JENNIFER PAULETTE (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:PAULETTE
Last Name:MILES-BROWN
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:109 SCARBRUSH CT
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-1017
Mailing Address - Country:US
Mailing Address - Phone:510-932-3814
Mailing Address - Fax:
Practice Address - Street 1:6781 LONDONDERRY WAY UNIT 4A
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-2094
Practice Address - Country:US
Practice Address - Phone:404-465-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No305S00000XManaged Care OrganizationsPoint of Service