Healthcare Provider Details

I. General information

NPI: 1912810953
Provider Name (Legal Business Name): VONDECAIR K BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6226 BANKERS ROAD SUITE 2
RACINE WI
53403
US

IV. Provider business mailing address

141 OHIO ST
RACINE WI
53405-1917
US

V. Phone/Fax

Practice location:
  • Phone: 262-260-8442
  • Fax: 262-996-7443
Mailing address:
  • Phone: 262-260-8442
  • Fax: 262-995-7443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: