Provider Demographics
NPI:1720002520
Name:BROWN, KAREN E (LMT, NCBTMB)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMT, NCBTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8533 W GOLDEN LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-2526
Mailing Address - Country:US
Mailing Address - Phone:623-476-7571
Mailing Address - Fax:
Practice Address - Street 1:8533 W GOLDEN LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-2526
Practice Address - Country:US
Practice Address - Phone:623-476-7571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-05106174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist