Healthcare Provider Details

I. General information

NPI: 1487165015
Provider Name (Legal Business Name): WENDY DAWN BROWN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 BISHOP ST
CORBIN KY
40701-1702
US

IV. Provider business mailing address

1241 YORKSHIRE ESTATES RD
LONDON KY
40744-8309
US

V. Phone/Fax

Practice location:
  • Phone: 606-528-2124
  • Fax: 606-528-8272
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3011537
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: