Provider Demographics
NPI:1710239496
Name:BROWNE, KIMBERLY L (ANP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:L
Last Name:BROWNE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:STE GENEVIEVE
Mailing Address - State:MO
Mailing Address - Zip Code:63670-0366
Mailing Address - Country:US
Mailing Address - Phone:573-883-4473
Mailing Address - Fax:573-883-4472
Practice Address - Street 1:575 PINE DR
Practice Address - Street 2:
Practice Address - City:STE GENEVIEVE
Practice Address - State:MO
Practice Address - Zip Code:63670-1446
Practice Address - Country:US
Practice Address - Phone:573-883-7474
Practice Address - Fax:573-883-7647
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006024303163W00000X
MO2012024135363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse