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General NPI Number Information
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NPI Number | 1194100701
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Entity Type | Individual
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Provider Name | KENDALL GILBERT BROWN FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1225 VALLEY VIEW DR
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City | LOGAN
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State | UT
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Zip | 84321-4585
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Country | US
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Telephone | 435-755-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 710 E 400 N
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City | WELLSVILLE
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State | UT
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Zip | 84339-9347
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Country | US
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Telephone | 505-918-5977
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP-02726
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License Number State | NM
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