Healthcare Provider Details

I. General information

NPI: 1700547908
Provider Name (Legal Business Name): RONITKA BROWN LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 BECKMAN ST
DAYTON OH
45410-2165
US

IV. Provider business mailing address

148 ERIE AVE
FAIRBORN OH
45324-4412
US

V. Phone/Fax

Practice location:
  • Phone: 937-271-2862
  • Fax: 937-853-2577
Mailing address:
  • Phone: 937-641-1063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number185285
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: