Provider Demographics
NPI:1366690315
Name:BREW, NANCY ELEANOR (ANP-FNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ELEANOR
Last Name:BREW
Suffix:
Gender:F
Credentials:ANP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 KENTUCKY ST # 309
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4200
Mailing Address - Country:US
Mailing Address - Phone:360-305-8965
Mailing Address - Fax:
Practice Address - Street 1:702 KENTUCKY ST # 309
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4200
Practice Address - Country:US
Practice Address - Phone:360-305-8965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP1399Medicaid
AK13991Medicaid
AK13991Medicaid