Provider Demographics
NPI:1922023423
Name:BROWN, MINDY MARIE (DC)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2257
Mailing Address - Country:US
Mailing Address - Phone:816-561-1500
Mailing Address - Fax:816-561-1565
Practice Address - Street 1:4020 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2257
Practice Address - Country:US
Practice Address - Phone:816-561-1500
Practice Address - Fax:816-561-1565
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007015880111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4102425OtherBLUE CROSS BLUE SHIELD
TN3973457Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL
TNV04501Medicare UPIN