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NPI Code Detail

MEDICARE: KENNETH BROWN

MEDICARE: KENNETH BROWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1372600000XAdult Companion
23747P1801XPersonal Care Attendant
3374U00000XHome Health Aide

General Provider Information

NPI Number : 1063256188
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH BROWN
Provider Business Mailing Address
First Line : 1475 BUFORD DR STE 403-773
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30043-3719
Country : US
Telephone Number : 678-300-8490
Fax Number :
Provider Business Practice Location Address
First Line : 1475 BUFORD DR STE 403-773
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30043-3719
Country : US
Telephone Number : 678-300-8490
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2024
Last Update Date : 05/22/2025

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Directions to “ KENNETH BROWN ” Practice Location

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