Provider Demographics
NPI:1336224351
Name:BREWSTER, JANNA L (ANP)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:L
Last Name:BREWSTER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32642
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99803-2642
Mailing Address - Country:US
Mailing Address - Phone:907-723-6656
Mailing Address - Fax:
Practice Address - Street 1:10301 GLACIER HWY
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8561
Practice Address - Country:US
Practice Address - Phone:907-789-2910
Practice Address - Fax:907-789-5545
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKQ64597Medicare UPIN