Provider Demographics
NPI:1194865535
Name:BROWN, KRISTIN RENE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:RENE
Last Name:BROWN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9500 STOCKDALE HWY STE 203
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3621
Practice Address - Country:US
Practice Address - Phone:661-587-8110
Practice Address - Fax:661-587-8220
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP11308363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner