Mary Anne Brown, ARNP
Individual provider Active NPI Nurse Practitioner · Olive Hill, KY
NPI 1710172259 · NPPES record last updated Jan 21, 2010
Key facts
- NPI
- 1710172259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 5272P (KY)
- Practice address
- 155 Bricklayer Street
Olive Hill, KY 41164-1268 - Phone
- (606) 286-4152
- Fax
- (606) 286-2385
- NPI assigned
- Sep 7, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220609001749 | KY | Order and Referring Only - Nurse Practitioner | 1355414160 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5272P | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Claire Medical Center, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5272P | KY | Yes |
Addresses
Primary practice location
155 Bricklayer Street
Olive Hill, KY 41164-1268
Mailing address
PO Box 1268
Olive Hill, KY 41164-1268
Phone (606) 286-4152
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0216374 | Other | KY | MEDICARE ID |
| 7100048040 | Medicaid | KY |
Other providers in Olive Hill, KY
- Cynthia Bond
- Heather Dawn Bond
- Stacy D Bond
- Amy Lynn Bowling
- Broadway Clinic Pharmacy Inc
- Charla Burchett
- Rebecca Lynn Cales
- Carter Pharmacist Group
- Carter Telehealth
- Allie Caudill
All providers in Olive Hill, KY · Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.