Provider Demographics
NPI:1255780888
Name:BROWN, LAQUENDRA D
Entity type:Individual
Prefix:MRS
First Name:LAQUENDRA
Middle Name:D
Last Name:BROWN
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 1:6505 PARKBELT DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-2538
Mailing Address - Country:US
Mailing Address - Phone:810-308-7947
Mailing Address - Fax:
Practice Address - Street 1:6505 PARKBELT DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-2538
Practice Address - Country:US
Practice Address - Phone:810-308-7947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-04
Last Update Date:2016-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other