Provider Demographics
NPI:1578541066
Name:BREWER, JANIS L (CRNP)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:L
Last Name:BREWER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3329
Mailing Address - Country:US
Mailing Address - Phone:724-222-2577
Mailing Address - Fax:724-228-5849
Practice Address - Street 1:400 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3329
Practice Address - Country:US
Practice Address - Phone:724-222-2577
Practice Address - Fax:724-228-5849
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008625363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA091291Medicare ID - Type UnspecifiedHGSADMINISTRATORS
PAQ44599Medicare UPIN