Healthcare Provider Details

I. General information

NPI: 1558705632
Provider Name (Legal Business Name): LISA-MARIE CAMILLE BROWN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2013
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2594 TRAILRIDGE DR E
LAFAYETTE CO
80026-3186
US

IV. Provider business mailing address

2594 TRAILRIDGE DR E
LAFAYETTE CO
80026-3186
US

V. Phone/Fax

Practice location:
  • Phone: 303-449-7740
  • Fax: 303-604-5393
Mailing address:
  • Phone: 303-449-7740
  • Fax: 303-604-5393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number0069385
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: