Healthcare Provider Details

I. General information

NPI: 1376563692
Provider Name (Legal Business Name): DOROTHY BROWN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 W 3RD ST
DAYTON OH
45428-9000
US

IV. Provider business mailing address

6432 GREENBROOK DR
TROTWOOD OH
45426-1308
US

V. Phone/Fax

Practice location:
  • Phone: 937-268-6511
  • Fax: 937-267-3975
Mailing address:
  • Phone: 937-268-6511
  • Fax: 937-267-3975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number212770
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: