Provider Demographics
NPI:1003398553
Name:BREWER, RACHEL (CNA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BREWER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5711 SARVIS AVE STE 510
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1367
Mailing Address - Country:US
Mailing Address - Phone:301-277-4337
Mailing Address - Fax:
Practice Address - Street 1:5711 SARVIS AVE STE 510
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1367
Practice Address - Country:US
Practice Address - Phone:301-277-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNA0000808909171M00000X
376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No171M00000XOther Service ProvidersCase Manager/Care Coordinator