Healthcare Provider Details

I. General information

NPI: 1033020771
Provider Name (Legal Business Name): KIANA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 JOHN WILLIAMS BLVD
BEDFORD IN
47421-9702
US

IV. Provider business mailing address

751 JOHNSON LN
BEDFORD IN
47421-8511
US

V. Phone/Fax

Practice location:
  • Phone: 812-709-3286
  • Fax:
Mailing address:
  • Phone: 812-583-4471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05016486A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: