Provider Demographics
NPI:1467752279
Name:BROWN-KAFKA, KRISTEN ANN (NCTMB,LMT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ANN
Last Name:BROWN-KAFKA
Suffix:
Gender:F
Credentials:NCTMB,LMT
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Mailing Address - Street 1:7207 GOLDEN WINGS RD
Mailing Address - Street 2:SUITE#300
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-3313
Mailing Address - Country:US
Mailing Address - Phone:904-483-2272
Mailing Address - Fax:904-483-2273
Practice Address - Street 1:7207 GOLDEN WINGS RD
Practice Address - Street 2:SUITE#300
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-3313
Practice Address - Country:US
Practice Address - Phone:904-483-2272
Practice Address - Fax:904-483-2273
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL36063225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist