MEDICARE: ANDRENA J BROWN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	2016030782	MO

General Provider Information

NPI Number	:	1295092666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRENA J BROWN MD

Provider Business Mailing Address
First Line	:	901 E 104TH ST
Second Line	:	MAILSTOP 400S
City	:	KANSAS CITY
State	:	MO
Zip	:	64131
Country	:	US
Telephone Number	:	816-932-1711
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 BROADWAY BLVD STE 316
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3305
Country	:	US
Telephone Number	:	816-932-1711
Fax Number	:	816-932-1719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2012
Last Update Date	:	06/07/2021

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