Provider Demographics
NPI:1831956077
Name:LAWLER, BROOKE JESSICA (PHARMD)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:JESSICA
Last Name:LAWLER
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 1:2204 ESSEX ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3211
Mailing Address - Country:US
Mailing Address - Phone:563-663-7356
Mailing Address - Fax:
Practice Address - Street 1:5415 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-4207
Practice Address - Country:US
Practice Address - Phone:443-873-9317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29644183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist