Provider Demographics
NPI:1669154399
Name:LEMIEUX, BROOKLYN (PHARMD)
Entity type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:
Last Name:LEMIEUX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 14TH ST W UNIT 305
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-2823
Mailing Address - Country:US
Mailing Address - Phone:701-516-4523
Mailing Address - Fax:
Practice Address - Street 1:506 W VILLARD ST
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-5017
Practice Address - Country:US
Practice Address - Phone:701-227-0191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH6502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist