Basic Information
| Provider Information | |||||||||
| NPI: | 1548400625 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | KENDALL | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 662 ROYAL CREST AVE | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372144814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158850942 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1324 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370643784 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157941542 | ||||||||
| FaxNumber: | 6157905967 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2009 | ||||||||
| LastUpdateDate: | 03/02/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 0000141182 | TN | Y | Nursing Service Providers | Registered Nurse |
No ID Information.