Provider Demographics
NPI:1891124004
Name:BREWSTER, NICOLE L (DNP, ACNP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:L
Last Name:BREWSTER
Suffix:
Gender:F
Credentials:DNP, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 PORTER ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15027-1360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9100 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5815
Practice Address - Country:US
Practice Address - Phone:412-367-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN646946163W00000X
OHRN.350834163WC0200X
PASP013975363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine