Healthcare Provider Details

I. General information

NPI: 1780024190
Provider Name (Legal Business Name): KIMBERLY WHITTINGTON BROWN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 06/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 SPRING HILL AVE
MOBILE AL
36604-3207
US

IV. Provider business mailing address

400 VETERANS AVE
BILOXI MS
39531-2410
US

V. Phone/Fax

Practice location:
  • Phone: 251-209-3900
  • Fax:
Mailing address:
  • Phone: 228-523-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number1-073262
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: