Provider Demographics
NPI:1255222949
Name:BROWN, KIMBERLY LOU
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LOU
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 1:99952 HIGHWAY 82
Mailing Address - Street 2:
Mailing Address - City:VIAN
Mailing Address - State:OK
Mailing Address - Zip Code:74962-6050
Mailing Address - Country:US
Mailing Address - Phone:918-705-1711
Mailing Address - Fax:
Practice Address - Street 1:114196 S 4730 RD
Practice Address - Street 2:
Practice Address - City:MULDROW
Practice Address - State:OK
Practice Address - Zip Code:74948-5889
Practice Address - Country:US
Practice Address - Phone:918-705-1711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health