Provider Demographics
NPI:1629223839
Name:BROWN, QUINTHONY ROYCE (LPN)
Entity Type:Individual
Prefix:MR
First Name:QUINTHONY
Middle Name:ROYCE
Last Name:BROWN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 BEDROCK DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050
Mailing Address - Country:US
Mailing Address - Phone:513-310-8235
Mailing Address - Fax:
Practice Address - Street 1:50 BEDROCK RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-2110
Practice Address - Country:US
Practice Address - Phone:513-310-8235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 105994164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse