Provider Demographics
NPI:1346993953
Name:BROWN, KIZZY R
Entity type:Individual
Prefix:
First Name:KIZZY
Middle Name:R
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 WESTMORELAND DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-1465
Mailing Address - Country:US
Mailing Address - Phone:336-609-4164
Mailing Address - Fax:
Practice Address - Street 1:1227 WESTMORELAND DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-1465
Practice Address - Country:US
Practice Address - Phone:336-417-9914
Practice Address - Fax:336-226-4674
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness