Provider Demographics
NPI:1851559116
Name:LALIBERTE-BROWN, AIMEE C (RN)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:C
Last Name:LALIBERTE-BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 S 89TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-2818
Mailing Address - Country:US
Mailing Address - Phone:414-443-0107
Mailing Address - Fax:
Practice Address - Street 1:909 S 89TH ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-2818
Practice Address - Country:US
Practice Address - Phone:414-443-0107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI147953030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35058800Medicaid