Individual
DR. KIMBERLY MICHELE HENLEY-BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 270-4460
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7781
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
012122
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00861484A
—
GA
01
—
906690
PROVIDER # FOR TRICARE
GA
Enumeration date
08/15/2006
Last updated
04/29/2024
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