Provider Demographics
NPI:1427426238
Name:BROWN, LEMMIE
Entity type:Individual
Prefix:
First Name:LEMMIE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHERONDA
Other - Middle Name:RAMONA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1 MID RIVERS MALL DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-4320
Mailing Address - Country:US
Mailing Address - Phone:636-387-6096
Mailing Address - Fax:636-387-6098
Practice Address - Street 1:1 MID RIVERS MALL DR
Practice Address - Street 2:SUITE 280
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-4320
Practice Address - Country:US
Practice Address - Phone:636-387-6096
Practice Address - Fax:636-387-6098
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO372500000X, 374U00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1013215128Medicaid
MO1821476474Medicaid