Provider Demographics
NPI:1245649110
Name:BROWN, KYONG-A B (APN-C)
Entity type:Individual
Prefix:MRS
First Name:KYONG-A
Middle Name:B
Last Name:BROWN
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 LOCKER RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38483-7200
Mailing Address - Country:US
Mailing Address - Phone:931-964-1087
Mailing Address - Fax:
Practice Address - Street 1:726 N LOCUST AVE
Practice Address - Street 2:1ST FLOOR SUITE D
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2865
Practice Address - Country:US
Practice Address - Phone:931-766-7056
Practice Address - Fax:931-766-7057
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN18930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily