Provider Demographics
NPI:1730530908
Name:BROWN, KRISTINA JEAN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:JEAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4600 MONTGOMERY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2600
Mailing Address - Country:US
Mailing Address - Phone:833-510-4357
Mailing Address - Fax:866-460-2997
Practice Address - Street 1:280 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1779
Practice Address - Country:US
Practice Address - Phone:339-368-7696
Practice Address - Fax:339-368-7649
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH072853-23363LF0000X
DELG0011791363LF0000X, 363LF0000X
MARN2265833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily