Provider Demographics
NPI:1699959403
Name:BREWER, DAVID LEWIS JR (CRNP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LEWIS
Last Name:BREWER
Suffix:JR
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:
Practice Address - Street 1:12 ST PAUL DR STE 204
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1035
Practice Address - Country:US
Practice Address - Phone:717-217-6886
Practice Address - Fax:717-217-6896
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009683363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50084024OtherCAPITAL BLUE CROSS-WMG
PA1579021OtherGATEWAY-WMG
PA102654070Medicaid
1699959403OtherNPI
MD950871OtherCAREFIRST MD BCBS
PA2099572OtherHIGHMARK BLUE SHIELD