Provider Demographics
NPI:1407448814
Name:BROWN, KAYLAN H (BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:KAYLAN
Middle Name:H
Last Name:BROWN
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MULLBERRY LN
Mailing Address - Street 2:
Mailing Address - City:IVA
Mailing Address - State:SC
Mailing Address - Zip Code:29655-8783
Mailing Address - Country:US
Mailing Address - Phone:864-245-7317
Mailing Address - Fax:
Practice Address - Street 1:609 N TOWNVILLE ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-2642
Practice Address - Country:US
Practice Address - Phone:864-245-7317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-07
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2391522083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine