Provider Demographics
NPI:1083327910
Name:BROWN, KATHY LEE (RN)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:LEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 WESTPOINT PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1534
Mailing Address - Country:US
Mailing Address - Phone:440-250-2871
Mailing Address - Fax:
Practice Address - Street 1:902 WESTPOINT PKWY STE 320
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1534
Practice Address - Country:US
Practice Address - Phone:440-250-2871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH319912163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse