Provider Demographics
NPI:1487273595
Name:BREWER, ANDREA MICHELLE (NP)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MICHELLE
Last Name:BREWER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2723 S 7TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-3558
Mailing Address - Country:US
Mailing Address - Phone:812-238-1730
Mailing Address - Fax:812-242-1565
Practice Address - Street 1:2723 S 7TH ST STE P
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-3562
Practice Address - Country:US
Practice Address - Phone:812-232-8594
Practice Address - Fax:812-232-5565
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28225652A163WX0106X
IN71010104A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health