Provider Demographics
NPI:1588141915
Name:BROWN, JAMILA
Entity type:Individual
Prefix:
First Name:JAMILA
Middle Name:
Last Name:BROWN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 8TH ST N APT 106
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-5244
Mailing Address - Country:US
Mailing Address - Phone:701-793-6778
Mailing Address - Fax:
Practice Address - Street 1:3838 12TH AVE N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2931
Practice Address - Country:US
Practice Address - Phone:701-234-4700
Practice Address - Fax:701-234-4475
Is Sole Proprietor?:No
Enumeration Date:2018-07-28
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR38203363LX0106X, 363LF0000X
CA95028985363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health