Basic Information
| Provider Information | |||||||||
| NPI: | 1962856138 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | WOODS | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WOODS | ||||||||
| OtherFirstName: | KRISTIN | ||||||||
| OtherMiddleName: | JORDAN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 337 | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370830337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156868160 | ||||||||
| FaxNumber: | 6156664403 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152845555 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2016 | ||||||||
| LastUpdateDate: | 06/04/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | 58599 | TN | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.