Healthcare Provider Details

I. General information

NPI: 1134862154
Provider Name (Legal Business Name): KATHRYN BROWN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 PAN AM E FWY NE STE 200
ALBUQUERQUE NM
87109-3443
US

IV. Provider business mailing address

321 VALENCIA DR NE
ALBUQUERQUE NM
87108-1742
US

V. Phone/Fax

Practice location:
  • Phone: 505-823-8282
  • Fax:
Mailing address:
  • Phone: 513-356-5860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2025-0167
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: