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Individual
HEIDI DAVONNE BROWN
Active
Individual
HEIDI DAVONNE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN, CMLD, CEO
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27075427A
IN
247ZC0005X
Clinical Laboratory Director (Non-physician)
15D2213193
IN
Other
Enumeration date
02/20/2018
Last updated
03/10/2021
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