Provider Demographics
NPI:1871014845
Name:BREWER, NIYAH SIMONE
Entity Type:Individual
Prefix:
First Name:NIYAH
Middle Name:SIMONE
Last Name:BREWER
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 1:7319 BRANCHWOOD TER
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2152
Mailing Address - Country:US
Mailing Address - Phone:240-330-2957
Mailing Address - Fax:
Practice Address - Street 1:7319 BRANCHWOOD TER
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2152
Practice Address - Country:US
Practice Address - Phone:240-330-2957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant