Provider Demographics
NPI:1689448300
Name:BREWSTER, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BREWSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 S SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661-3034
Mailing Address - Country:US
Mailing Address - Phone:304-416-1496
Mailing Address - Fax:
Practice Address - Street 1:37 S SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3034
Practice Address - Country:US
Practice Address - Phone:304-416-1496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker