Healthcare Provider Details

I. General information

NPI: 1821953944
Provider Name (Legal Business Name): ELIZABETH L BROWN LMT, LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 OFFICE PARK PLZ STE 11
JACKSON MS
39206-4108
US

IV. Provider business mailing address

114 OFFICE PARK PLZ STE 11
JACKSON MS
39206-4108
US

V. Phone/Fax

Practice location:
  • Phone: 769-359-8753
  • Fax:
Mailing address:
  • Phone: 769-359-8753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number4091
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: