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General NPI Number Information
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NPI Number | 1134738172
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Entity Type | Individual
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Provider Name | RANDOL BROWN ARNP
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Gender | Male
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 103 KEYSTONE DR
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City | RICHMOND
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State | KY
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Zip | 40475-7988
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Country | US
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Telephone | 859-353-8884
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Fax |
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Provider Business Mailing Address
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Address Line | 210 MALLORY SPG
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City | BEREA
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State | KY
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Zip | 40403-9653
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Country | US
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Telephone | 859-302-0110
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 61087945
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3017196
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License Number State | KY
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