Provider Demographics
NPI:1316313588
Name:BREWER, ELIZABETH ANNE (DPT)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:BREWER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CURLE ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669
Mailing Address - Country:US
Mailing Address - Phone:434-485-9928
Mailing Address - Fax:
Practice Address - Street 1:23 CURLE ROAD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669
Practice Address - Country:US
Practice Address - Phone:434-485-9928
Practice Address - Fax:757-873-8780
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052096282251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4978935Medicaid
VA49-6616Medicare UPIN