Provider Demographics
NPI:1477223923
Name:BROWN, JOLINDA LOU (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JOLINDA
Middle Name:LOU
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:312 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:CO
Mailing Address - Zip Code:81226-1410
Mailing Address - Country:US
Mailing Address - Phone:719-339-9596
Mailing Address - Fax:719-526-2998
Practice Address - Street 1:2751 WILDERNESS RD BLDG 9481
Practice Address - Street 2:
Practice Address - City:FT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4719
Practice Address - Country:US
Practice Address - Phone:719-526-5142
Practice Address - Fax:719-526-2998
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPN.0043138164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPN.0043138OtherDORA