Brockman, Jennifer Elaine
Brockman, Jennifer Elaine is an sole proprietor health care provider with primary practice located at 321 W Promenade St , Mexico MO 65265-2719. She recently has only one registered license in Allopathic & Osteopathic Physicians / Forensic Psychiatry, which is considered as her primary health care specialty. Brockman, Jennifer Elaine can be contacted via phone (573) 582-1234.Contact Information
Primary practice address
321 W Promenade St
Mexico MO 65265-2719
Phone: (573) 582-1234
Fax: (573) 582-1212
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Forensic Psychiatry | 2084F0202X | 2004003502 | Missouri |
| Allopathic & Osteopathic Physicians / Forensic Psychiatry | 2084F0202X | A96005 | California |
Profile Details
| NPI number | 1346323870 |
|---|---|
| LBN Legal business name | Brockman, Jennifer Elaine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346323870 | NPPES |
| California | Other | A96005 | STATE LICENSE |
| California | Other | 2004003502 | STATE LICENSE |
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