Healthcare Provider Details

I. General information

NPI: 1225949969
Provider Name (Legal Business Name): TABATHA LLOYD-BREWER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 HARDING ST
DEFIANCE OH
43512
US

IV. Provider business mailing address

614 HUDDLE RD
NAPOLEON OH
43545-9111
US

V. Phone/Fax

Practice location:
  • Phone: 844-534-3638
  • Fax:
Mailing address:
  • Phone: 419-966-7172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.151219.MEDS-IV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: