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General NPI Number Information
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NPI Number | 1447097647
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Entity Type | Individual
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Provider Name | KENISHA BROWN
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Gender | Female
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Dates
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Enumeration Date | 07/15/2024
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 824 N 99TH AVE
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City | AVONDALE
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State | AZ
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Zip | 85323-5324
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Country | US
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Telephone | 623-907-6520
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Fax |
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Provider Business Mailing Address
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Address Line | 824 N 99TH AVE STE 107-108
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City | AVONDALE
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State | AZ
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Zip | 85323-5324
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Country | US
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Telephone | 623-907-1457
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 313512
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | RN206881
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN206881
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License Number State | AZ
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