Provider Demographics
NPI:1275246019
Name:BROWN, MICHAELA KENNEDY (PA-C)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:KENNEDY
Last Name:BROWN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2200 DUNAVANT ST APT 505
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-6922
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2202 CAROLINA PL STE 200
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-8807
Practice Address - Country:US
Practice Address - Phone:980-487-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-26
Last Update Date:2024-12-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical