Provider Demographics
NPI:1407010127
Name:BROWN, BETTIE ANN (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:BETTIE
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1613
Mailing Address - Country:US
Mailing Address - Phone:816-516-6927
Mailing Address - Fax:816-268-8849
Practice Address - Street 1:637 E 72ND ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1613
Practice Address - Country:US
Practice Address - Phone:816-516-6927
Practice Address - Fax:816-268-8849
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104211163W00000X
KS14-79445-051163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse