Provider Demographics
NPI:1386225399
Name:BROWNELL, ABIGAIL (DO)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:BROWNELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N1581 WOODDALE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-4127
Mailing Address - Country:US
Mailing Address - Phone:847-287-8381
Mailing Address - Fax:
Practice Address - Street 1:N1581 WOODDALE DR
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-4127
Practice Address - Country:US
Practice Address - Phone:847-287-8381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program