Healthcare Provider Details

I. General information

NPI: 1568227569
Provider Name (Legal Business Name): KIMBERLY E BROWN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2032 CUMBERLAND AVE
MIDDLESBORO KY
40965-2829
US

IV. Provider business mailing address

2032 CUMBERLAND AVE
MIDDLESBORO KY
40965-2829
US

V. Phone/Fax

Practice location:
  • Phone: 606-248-4833
  • Fax: 606-248-4836
Mailing address:
  • Phone: 606-248-4833
  • Fax: 606-248-4836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4012045
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: