Provider Demographics
NPI:1255093019
Name:BROWN, LATRICE LORELLE (NCRMA, CPT, BLS)
Entity type:Individual
Prefix:
First Name:LATRICE
Middle Name:LORELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:NCRMA, CPT, BLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6349 WALNUT FOREST CT
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-5328
Mailing Address - Country:US
Mailing Address - Phone:347-872-2304
Mailing Address - Fax:
Practice Address - Street 1:6349 WALNUT FOREST CT
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-5328
Practice Address - Country:US
Practice Address - Phone:347-872-2304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAC2A9A8P9246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy