Healthcare Provider Details

I. General information

NPI: 1437074069
Provider Name (Legal Business Name): DEASIA MARIE GREEN-BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 ZINK RD APT 2C
BEAVERCREEK OH
45324-2272
US

IV. Provider business mailing address

2080 ZINK RD APT 2C
BEAVERCREEK OH
45324-2272
US

V. Phone/Fax

Practice location:
  • Phone: 614-815-3249
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: