Provider Demographics
NPI:1508640178
Name:SAWYER BREWER, MAMIE (RN)
Entity Type:Individual
Prefix:
First Name:MAMIE
Middle Name:
Last Name:SAWYER BREWER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 E RIDDLE AVE
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3206
Mailing Address - Country:US
Mailing Address - Phone:440-506-5506
Mailing Address - Fax:
Practice Address - Street 1:559 E RIDDLE AVE
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3206
Practice Address - Country:US
Practice Address - Phone:330-346-3039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.463206163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)