Individual provider Active NPI

Kaydee Brown

  • Obstetrics & Gynecology Nurse Practitioner
  • Normal, IL
National Provider Identifier
1902513013
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
209.026289 Issued in IL
Practice address
1300 Franklin Ave Ste 330
Normal, IL 61761-4204
Phone
(309) 808-0940
NPI assigned
Oct 31, 2022
Last updated
Jul 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 209.026289 IL Primary

Addresses

Primary practice location

1300 Franklin Ave Ste 330
Normal, IL 61761-4204

Mailing address

1300 Franklin Ave Ste 330
Normal, IL 61761-4204
Phone (309) 808-3068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
209.026289ILMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nona Fulk, M.D., S.C. CurrentSince Nov 6, 2022 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1300 Franklin Ave
Ste 330
Normal, IL 61761
Phone (309) 454-7400

Interoperability endpoints

  • Direct secure messaging: kaydee@fulk.gwaydirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1902513013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE STE 330",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617614204",
            "telephone_number": "309-808-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE STE 330",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617614204",
            "telephone_number": "309-808-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KAYDEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IL",
            "license": "209.026289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.