National Provider Identifier

Jessica Elise Brown, PA

Jessica Elise Brown, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Kenmore, NY and a listed phone number of (716) 447-6100.

NPI 1477513034Kenmore, NYPhysician Assistant

Profile Overview

NPI
1477513034
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
March 27, 2006
Last Updated
July 10, 2018

Practice Location

  • 2950 Elmwood Ave
  • Kenmore, NY 14217

Phone: (716) 447-6100

Mailing Address

  • 908 Niagara Falls Blvd Ste 208
  • North Tonawanda, NY 14120-2019

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1477513034
Entity Type
Individual
Last Name
Brown
First Name
Jessica
Middle Name
Elise
Credential
PA
Provider Other Last Name
Lightner
Provider Other First Name
Jessica
Provider Other Middle Name
Elise
Provider Other Last Name Type Code
1
Mailing Street Address
908 Niagara Falls Blvd Ste 208
Mailing City
North Tonawanda
Mailing State
NY
Mailing ZIP Code
14120-2019
Mailing Country
US
Mailing Phone
(716) 692-3302
Mailing Fax
(716) 692-4342
Practice Street Address
2950 Elmwood Ave
Practice City
Kenmore
Practice State
NY
Practice ZIP Code
14217
Practice Country
US
Practice Phone
(716) 447-6100
Practice Fax
(716) 876-5079
Enumeration Date
March 27, 2006
Last Updated
July 10, 2018
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)
Other Identifiers
04054766 (NY)