Provider Demographics
NPI:1548090103
Name:BROWN, KIMBERLY MARIE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 60
Mailing Address - Street 2:
Mailing Address - City:HOOKER
Mailing Address - State:OK
Mailing Address - Zip Code:73945-9640
Mailing Address - Country:US
Mailing Address - Phone:580-461-9112
Mailing Address - Fax:
Practice Address - Street 1:101 GLAYDAS ST
Practice Address - Street 2:
Practice Address - City:HOOKER
Practice Address - State:OK
Practice Address - Zip Code:73945
Practice Address - Country:US
Practice Address - Phone:580-652-1100
Practice Address - Fax:866-422-1819
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK219626363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily