Provider Demographics
NPI:1154733392
Name:BREWER, JAMIE L (NP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:BREWER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1697
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MS
Mailing Address - Zip Code:39073-1697
Mailing Address - Country:US
Mailing Address - Phone:601-891-8657
Mailing Address - Fax:949-561-5551
Practice Address - Street 1:2785 HIGHWAY 49 S STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MS
Practice Address - Zip Code:39073-9411
Practice Address - Country:US
Practice Address - Phone:601-832-2616
Practice Address - Fax:949-561-5551
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSR891185207RE0101X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism