Provider Demographics
NPI:1336908201
Name:BROWN, LYNETTE LEANN (LPN)
Entity Type:Individual
Prefix:
First Name:LYNETTE
Middle Name:LEANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10454 TROY ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-7407
Mailing Address - Country:US
Mailing Address - Phone:678-708-9323
Mailing Address - Fax:
Practice Address - Street 1:10454 TROY ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-7407
Practice Address - Country:US
Practice Address - Phone:678-708-9323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPN.0337750164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse