Provider Demographics
NPI:1730469164
Name:BROWN, KATHRYN M (MD)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:61 SAINT ALBANS ST S
Mailing Address - Street 2:APT A
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3542
Mailing Address - Country:US
Mailing Address - Phone:763-442-4290
Mailing Address - Fax:
Practice Address - Street 1:1414 MARYLAND AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-2824
Practice Address - Country:US
Practice Address - Phone:763-442-4290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN55225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program