Provider Demographics
NPI:1720338387
Name:BROWN, LAKESHA N (MPA)
Entity Type:Individual
Prefix:MS
First Name:LAKESHA
Middle Name:N
Last Name:BROWN
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8422
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32239-0422
Mailing Address - Country:US
Mailing Address - Phone:904-253-1288
Mailing Address - Fax:904-253-1972
Practice Address - Street 1:900 UNIVERSITY BLVD N
Practice Address - Street 2:MC-66
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5530
Practice Address - Country:US
Practice Address - Phone:904-253-1288
Practice Address - Fax:904-253-1972
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator