Provider Demographics
NPI:1306647771
Name:BREWER, MELANIE BROOKE (NP)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:BROOKE
Last Name:BREWER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 554
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:KS
Mailing Address - Zip Code:67950-0554
Mailing Address - Country:US
Mailing Address - Phone:806-268-0336
Mailing Address - Fax:
Practice Address - Street 1:401 CHEYENNE
Practice Address - Street 2:
Practice Address - City:SATANTA
Practice Address - State:KS
Practice Address - Zip Code:67870-8748
Practice Address - Country:US
Practice Address - Phone:620-682-8414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSTMP-162858363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner