Provider Demographics
NPI:1386997666
Name:BROUWER, LAURI JANENE (ND)
Entity type:Individual
Prefix:DR
First Name:LAURI
Middle Name:JANENE
Last Name:BROUWER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4440 N 36TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3589
Mailing Address - Country:US
Mailing Address - Phone:480-588-6856
Mailing Address - Fax:480-307-6019
Practice Address - Street 1:4440 N 36TH ST STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3589
Practice Address - Country:US
Practice Address - Phone:480-588-6856
Practice Address - Fax:480-307-6019
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12-1341175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath