Provider Demographics
NPI:1477045722
Name:BROWN, KIMBERLY ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:STADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3084 N MAIZE RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-7359
Mailing Address - Country:US
Mailing Address - Phone:316-347-2587
Mailing Address - Fax:316-347-2888
Practice Address - Street 1:3084 N MAIZE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-7359
Practice Address - Country:US
Practice Address - Phone:316-347-2587
Practice Address - Fax:316-347-2888
Is Sole Proprietor?:No
Enumeration Date:2018-06-02
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist