Healthcare Provider Details

I. General information

NPI: 1922963206
Provider Name (Legal Business Name): RONNIE EARL BROWN JR. RRT, RCP, E-AEC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 COTTONWOOD RD
YOUNGSVILLE NC
27596-9717
US

IV. Provider business mailing address

90 COTTONWOOD RD
YOUNGSVILLE NC
27596-9717
US

V. Phone/Fax

Practice location:
  • Phone: 661-330-9392
  • Fax: 661-330-9392
Mailing address:
  • Phone: 661-330-9392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number9740
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: