Provider Demographics
NPI:1326651928
Name:BROWN, KYLE DAVID (FNP, DNP)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:DAVID
Last Name:BROWN
Suffix:
Gender:M
Credentials:FNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 AIRMONT DR
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-4903
Mailing Address - Country:US
Mailing Address - Phone:716-338-8149
Mailing Address - Fax:
Practice Address - Street 1:7 AIRMONT DR
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-4903
Practice Address - Country:US
Practice Address - Phone:716-338-8149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346483363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily