Healthcare Provider Details

I. General information

NPI: 1134492515
Provider Name (Legal Business Name): KURTIS BROWN ND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2012
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2812 W COLORADO AVE STE 106
COLORADO SPRINGS CO
80904-2481
US

IV. Provider business mailing address

1420 S 21ST ST
COLORADO SPRINGS CO
80904-4204
US

V. Phone/Fax

Practice location:
  • Phone: 719-471-8411
  • Fax: 719-417-4718
Mailing address:
  • Phone: 719-471-8411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number11-1244
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number44
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: