Healthcare Provider Details

I. General information

NPI: 1861869711
Provider Name (Legal Business Name): KRISTEN BROWN RN, CLC, CCCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2015
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 ROCKY HILL RD
REHOBOTH MA
02769-1520
US

IV. Provider business mailing address

18 ROCKY HILL RD
REHOBOTH MA
02769-1520
US

V. Phone/Fax

Practice location:
  • Phone: 508-431-0850
  • Fax:
Mailing address:
  • Phone: 508-431-0850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN283329
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN283329
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN283329
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN283329
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: