Kendrick Kenyon Brown
Individual provider Active NPI Driver · Baton Rouge, LA
NPI 1225752173 · NPPES record last updated Oct 3, 2022
Key facts
- NPI
- 1225752173
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 006586456 (LA)
- Practice address
- 2136 Lobdell Blvd Apt 802
Baton Rouge, LA 70806-1342 - Phone
- (225) 929-1667
- NPI assigned
- Oct 3, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006586456 | LA | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 006586456 | LA | Yes |
Addresses
Primary practice location
2136 Lobdell Blvd Apt 802
Baton Rouge, LA 70806-1342
Mailing address
2136 Lobdell Blvd Apt 802
Baton Rouge, LA 70806-1342
Phone (225) 929-1667
Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.