Provider Demographics
NPI:1487723235
Name:BREWER, BYRON LEE JR (RNFA)
Entity type:Individual
Prefix:MR
First Name:BYRON
Middle Name:LEE
Last Name:BREWER
Suffix:JR
Gender:M
Credentials:RNFA
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Mailing Address - Street 1:312 CLEAR LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-0276
Mailing Address - Country:US
Mailing Address - Phone:985-249-5020
Mailing Address - Fax:985-249-5092
Practice Address - Street 1:405 TANGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1756
Practice Address - Country:US
Practice Address - Phone:985-649-3440
Practice Address - Fax:985-661-8554
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2008-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LARN097365163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant