Provider Demographics
NPI:1891800504
Name:BROWN, KRISTIE LOUANN (DNP, APRN)
Entity type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:LOUANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 HARRY HINES BLVD # CC6008
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7709
Mailing Address - Country:US
Mailing Address - Phone:469-419-0642
Mailing Address - Fax:
Practice Address - Street 1:5200 HARRY HINES BLVD # CC6008
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7709
Practice Address - Country:US
Practice Address - Phone:469-419-0642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX653103363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164508702Medicaid