Provider Demographics
NPI:1235938176
Name:BREW, RONALD DEAN
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:DEAN
Last Name:BREW
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 S 55TH ST # NEUSA
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2323
Mailing Address - Country:US
Mailing Address - Phone:402-672-8234
Mailing Address - Fax:
Practice Address - Street 1:1530 S 55TH ST # NEUSA
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-2323
Practice Address - Country:US
Practice Address - Phone:402-672-8234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant