Provider Demographics
NPI:1982486569
Name:BROWN, LISA N (SCD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:N
Last Name:BROWN
Suffix:
Gender:F
Credentials:SCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 PRESTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-2105
Mailing Address - Country:US
Mailing Address - Phone:434-207-2151
Mailing Address - Fax:
Practice Address - Street 1:1010 PRESTON AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-2105
Practice Address - Country:US
Practice Address - Phone:434-207-2104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2833374J00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker