1467752279 NPI number — MRS. KRISTEN ANN BROWN-KAFKA NCTMB,L.M.T

Table of content: MRS. KRISTEN ANN BROWN-KAFKA NCTMB,L.M.T (NPI 1467752279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467752279 NPI number — MRS. KRISTEN ANN BROWN-KAFKA NCTMB,L.M.T

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN-KAFKA
Provider First Name:
KRISTEN
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NCTMB,L.M.T
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467752279
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7207 GOLDEN WINGS RD
Provider Second Line Business Mailing Address:
SUITE#300
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32244-3313
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-483-2272
Provider Business Mailing Address Fax Number:
904-483-2273

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7207 GOLDEN WINGS RD
Provider Second Line Business Practice Location Address:
SUITE#300
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32244-3313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-483-2272
Provider Business Practice Location Address Fax Number:
904-483-2273
Provider Enumeration Date:
10/26/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  36063 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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