Provider Demographics
NPI:1629755806
Name:BROWNLEE, LUCINDA
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:
Last Name:BROWNLEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 MERRIWEATHER LN
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-2432
Mailing Address - Country:US
Mailing Address - Phone:161-856-7321
Mailing Address - Fax:
Practice Address - Street 1:205 MERRIWEATHER LN
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-2432
Practice Address - Country:US
Practice Address - Phone:618-567-3216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver