Healthcare Provider Details

I. General information

NPI: 1447671458
Provider Name (Legal Business Name): KAREN JO BROWN CNA, CPM, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2013
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 WOODDUCK LN
GEORGETOWN KY
40324-9256
US

IV. Provider business mailing address

501 WOODDUCK LN
GEORGETOWN KY
40324-9256
US

V. Phone/Fax

Practice location:
  • Phone: 859-494-7481
  • Fax:
Mailing address:
  • Phone: 859-494-7481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number50109536
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: