Provider Demographics
NPI:1548493083
Name:BROWN, LIZZETTE P (RPH)
Entity type:Individual
Prefix:
First Name:LIZZETTE
Middle Name:P
Last Name:BROWN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 BARNHILL DR
Mailing Address - Street 2:ROC 1201
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5128
Mailing Address - Country:US
Mailing Address - Phone:317-274-2335
Mailing Address - Fax:317-278-0792
Practice Address - Street 1:702 BARNHILL DR
Practice Address - Street 2:ROC 1201
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5128
Practice Address - Country:US
Practice Address - Phone:317-274-2335
Practice Address - Fax:317-278-0792
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015395A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist