Provider Demographics
NPI:1710416797
Name:BROWN, KRISTEN NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:NICOLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:NICOLE
Other - Last Name:BEAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:801 PRINCETON AVE SW STE 707
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1395
Mailing Address - Country:US
Mailing Address - Phone:205-780-4330
Mailing Address - Fax:205-780-7775
Practice Address - Street 1:801 PRINCETON AVE SW STE 707
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1309
Practice Address - Country:US
Practice Address - Phone:205-780-4330
Practice Address - Fax:205-780-7775
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00009178207R00000X
ALMD.48284207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL327759Medicaid
ALMD.48284OtherMD LICENSE