Provider Demographics
NPI:1922052885
Name:BROWN, CHERYL LYNN (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 PACKARD RD
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:MI
Mailing Address - Zip Code:49248-9731
Mailing Address - Country:US
Mailing Address - Phone:517-436-3946
Mailing Address - Fax:
Practice Address - Street 1:1334 PACKARD RD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:MI
Practice Address - Zip Code:49248-9731
Practice Address - Country:US
Practice Address - Phone:517-436-3946
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704164513174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist