Provider Demographics
NPI:1114458890
Name:BROWNLEE, CHARLA (LPN)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:
Last Name:BROWNLEE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20609 SELFRIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7041
Mailing Address - Country:US
Mailing Address - Phone:216-973-7647
Mailing Address - Fax:
Practice Address - Street 1:20609 SELFRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HIGHLAND HILLS
Practice Address - State:OH
Practice Address - Zip Code:44122-7041
Practice Address - Country:US
Practice Address - Phone:216-973-7647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.152784164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse