Provider Demographics
NPI:1073946737
Name:BROWN, KATHLEEN LAIRD (PNP)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:LAIRD
Last Name:BROWN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WHEELER ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5700
Mailing Address - Country:US
Mailing Address - Phone:912-353-7744
Mailing Address - Fax:912-355-9124
Practice Address - Street 1:2 WHEELER ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5700
Practice Address - Country:US
Practice Address - Phone:912-353-7744
Practice Address - Fax:912-355-9124
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN255069363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN255069OtherMEDICAL LICENSE