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NPI Code Detail

MEDICARE: MRS. JULIA CLARK-BROWNELL LPN

MEDICARE: MRS. JULIA CLARK-BROWNELL LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse4703115769MI

General Provider Information

NPI Number : 1578181301
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIA CLARK-BROWNELL LPN
Provider Business Mailing Address
First Line : 15945 WOOD RD
Second Line :
City : LANSING
State : MI
Zip : 48906-1746
Country : US
Telephone Number : 517-652-1327
Fax Number :
Provider Business Practice Location Address
First Line : 15945 WOOD RD
Second Line :
City : LANSING
State : MI
Zip : 48906-1746
Country : US
Telephone Number : 517-652-1327
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2020
Last Update Date : 07/09/2020

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