Provider Demographics
NPI:1851581425
Name:BREWER, SHANNON DAWN (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:DAWN
Last Name:BREWER
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7050 AIR DEPOT BLVD BLDG 1094
Mailing Address - Street 2:
Mailing Address - City:TINKER AFB
Mailing Address - State:OK
Mailing Address - Zip Code:73145-8716
Mailing Address - Country:US
Mailing Address - Phone:405-582-6325
Mailing Address - Fax:405-736-2890
Practice Address - Street 1:7050 AIR DEPOT BLVD
Practice Address - Street 2:
Practice Address - City:TINKER AFB
Practice Address - State:OK
Practice Address - Zip Code:73145-8716
Practice Address - Country:US
Practice Address - Phone:405-582-6325
Practice Address - Fax:405-736-2890
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10372183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist