Provider Demographics
NPI:1295085322
Name:PEABODY BROWN, KIMBERLY BETH (CNM)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:BETH
Last Name:PEABODY BROWN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 NORTH 30TH ST.
Mailing Address - Street 2:SAINT VINCENT HEALTHCARE
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101
Mailing Address - Country:US
Mailing Address - Phone:406-237-3620
Mailing Address - Fax:
Practice Address - Street 1:1233 NORTH 30TH ST.
Practice Address - Street 2:SAINT VINCENT HEALTHCARE
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101
Practice Address - Country:US
Practice Address - Phone:406-237-3620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22518367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife