Provider Demographics
NPI:1427446962
Name:BREWER, CHERYL ANNE
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANNE
Last Name:BREWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:ANNE
Other - Last Name:KEAGLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3392 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-9346
Mailing Address - Country:US
Mailing Address - Phone:517-750-4257
Mailing Address - Fax:
Practice Address - Street 1:3392 PINE RIDGE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-9346
Practice Address - Country:US
Practice Address - Phone:517-750-4257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide