Provider Demographics
NPI:1366138372
Name:BROWN, KYRSTEN (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KYRSTEN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11175 CROSSETO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3992
Mailing Address - Country:US
Mailing Address - Phone:804-551-4336
Mailing Address - Fax:
Practice Address - Street 1:1489 W WARM SPRINGS RD STE 110
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7367
Practice Address - Country:US
Practice Address - Phone:702-403-2124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV833722261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care