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NPI 1124115472

NPI 1124115472 : CHASTITY S BROWN APRN : BURKESVILLE, KY

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General NPI Number Information
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    NPI Number           |    1124115472
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    Entity Type          |    Individual 
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    Provider Name        |    CHASTITY S BROWN APRN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/06/2006
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    Last Update Date     |    05/18/2016
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Provider Practice Location Address
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    Address Line         |    360 KEEN ST 
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    City                 |    BURKESVILLE
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    State                |    KY
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    Zip                  |    42717-1080
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    Country              |    US
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    Telephone            |    270-864-2889
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    Fax                  |    270-864-2229
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1080 
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    City                 |    BURKESVILLE
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    State                |    KY
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    Zip                  |    42717-1080
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    Country              |    US
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    Telephone            |    270-864-1472
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    Fax                  |    270-864-1693
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    3004693
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    License Number State |    KY
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