Provider Demographics
NPI:1033764980
Name:BROWN, KIMBERLY KAYE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAYE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18222 WIDCOMBE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3249
Mailing Address - Country:US
Mailing Address - Phone:281-858-5739
Mailing Address - Fax:
Practice Address - Street 1:18222 WIDCOMBE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3249
Practice Address - Country:US
Practice Address - Phone:281-858-5739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX965812163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse