Provider Demographics
NPI:1487835732
Name:BROWN, VELETTA
Entity type:Individual
Prefix:
First Name:VELETTA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VELETTA
Other - Middle Name:
Other - Last Name:BEATTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1620 FREDERICA ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-4807
Mailing Address - Country:US
Mailing Address - Phone:270-686-6040
Mailing Address - Fax:270-686-6050
Practice Address - Street 1:1620 FREDERICA ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-4807
Practice Address - Country:US
Practice Address - Phone:270-686-6040
Practice Address - Fax:270-686-6050
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009257363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily