MEDICARE: LACHELLE BROWN

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
1	372600000X	Adult Companion	813286464	WI

General Provider Information

NPI Number	:	1760920508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LACHELLE BROWN

Provider Business Mailing Address
First Line	:	3292 N 60TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-3168
Country	:	US
Telephone Number	:	414-388-5492
Fax Number	:

Provider Business Practice Location Address
First Line	:	3292 N 60TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-3168
Country	:	US
Telephone Number	:	414-388-5492
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2017
Last Update Date	:	01/31/2017

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Directions to “ LACHELLE BROWN ” Practice Location

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