Provider Demographics
NPI:1417149220
Name:BROWN, KRISTIN MAUREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:MAUREEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:KRISTIN
Other - Middle Name:MAUREEN
Other - Last Name:FLYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8170 LAGUNA BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7901
Mailing Address - Country:US
Mailing Address - Phone:916-691-5999
Mailing Address - Fax:916-691-5940
Practice Address - Street 1:10470 OLD PLACERVILLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2539
Practice Address - Country:US
Practice Address - Phone:800-470-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124831208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA124831OtherMEDICAL LICENSE