Basic Information
Provider Information
NPI: 1457350407
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: KATHRYN
MiddleName: M
NamePrefix: MRS.
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 262 DANNY THOMAS PL # MS 515
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381053678
CountryCode: US
TelephoneNumber: 9012912427
FaxNumber: 9013790771
Practice Location
Address1: 262 DANNY THOMAS PL
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381053678
CountryCode: US
TelephoneNumber: 9015953300
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/20/2005
LastUpdateDate: 03/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X134062TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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