Provider Demographics
NPI:1992575773
Name:BROWN, KERI (ND)
Entity type:Individual
Prefix:DR
First Name:KERI
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:PONCHA SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81242-0147
Mailing Address - Country:US
Mailing Address - Phone:719-423-0306
Mailing Address - Fax:
Practice Address - Street 1:9485 COUNTY ROAD 120
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-9737
Practice Address - Country:US
Practice Address - Phone:719-423-0306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000079175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath