Provider Demographics
NPI:1467073361
Name:BROWN, LESA Y (REGISTER NURSE)
Entity Type:Individual
Prefix:
First Name:LESA
Middle Name:Y
Last Name:BROWN
Suffix:
Gender:F
Credentials:REGISTER NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8224 SIR LIONEL PL
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23237-4725
Mailing Address - Country:US
Mailing Address - Phone:804-239-0839
Mailing Address - Fax:
Practice Address - Street 1:8224 SIR LIONEL PL
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23237-4725
Practice Address - Country:US
Practice Address - Phone:804-239-0839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001223560163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health