MEDICARE: KATHRYN BROWN RN

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
1	302R00000X	Health Maintenance Organization	395040	OH

General Provider Information

NPI Number	:	1336560697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN BROWN RN

Provider Business Mailing Address
First Line	:	1006 ENGLEWOOD RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2046
Country	:	US
Telephone Number	:	216-355-7062
Fax Number	:

Provider Business Practice Location Address
First Line	:	1006 ENGLEWOOD RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2046
Country	:	US
Telephone Number	:	216-355-7062
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2014
Last Update Date	:	01/03/2014

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