Provider Demographics
NPI:1538812094
Name:BREWER, BRIAN T SR (RN)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:T
Last Name:BREWER
Suffix:SR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LEHNER RD
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1836
Mailing Address - Country:US
Mailing Address - Phone:207-300-2471
Mailing Address - Fax:
Practice Address - Street 1:2 LEHNER RD
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1836
Practice Address - Country:US
Practice Address - Phone:207-300-2471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER037815163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty