Provider Demographics
NPI:1093479883
Name:BREWER, LUCY (RRT)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:
Last Name:BREWER
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16990 NW 133RD TER
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-7840
Mailing Address - Country:US
Mailing Address - Phone:816-778-9985
Mailing Address - Fax:
Practice Address - Street 1:16990 NW 133RD TER
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-7840
Practice Address - Country:US
Practice Address - Phone:816-778-9985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011038931227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered