Individual
KEVIN NATHANIEL BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
560 S MAPLE ST STE 400, WACONIA, MN 55387-1757
(952) 442-8011
(952) 442-7852
Mailing address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
(952) 442-7852
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
200700752
NC
2084N0600X
Clinical Neurophysiology Physician
Primary
16308
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5907716
—
NC
01
—
P00417871
RAILROAD MEDICARE
NC
Enumeration date
01/24/2007
Last updated
03/02/2018
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