Provider Demographics
NPI:1225057664
Name:BROWN, LINDSAY KATHRYN (PAC)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:KATHRYN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 DEER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BURTCHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48059-3645
Mailing Address - Country:US
Mailing Address - Phone:810-385-2290
Mailing Address - Fax:
Practice Address - Street 1:17515 W 9 MILE RD STE 340
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4426
Practice Address - Country:US
Practice Address - Phone:248-569-2695
Practice Address - Fax:248-569-7250
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003334363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical