Provider Demographics
NPI:1003614082
Name:BROWN, KAYELEIGH ANNEMARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:KAYELEIGH
Middle Name:ANNEMARIE
Last Name:BROWN
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1087 BARBER TER NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-3701
Mailing Address - Country:US
Mailing Address - Phone:616-558-8536
Mailing Address - Fax:
Practice Address - Street 1:1355 BOGUE ST
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-6207
Practice Address - Country:US
Practice Address - Phone:517-432-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704370434363L00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse