Provider Demographics
NPI:1447144639
Name:BREWER, ROTIKA MADAIR (LPN)
Entity type:Individual
Prefix:MS
First Name:ROTIKA
Middle Name:MADAIR
Last Name:BREWER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10015 KINGS PARADE BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-5718
Mailing Address - Country:US
Mailing Address - Phone:757-812-3102
Mailing Address - Fax:
Practice Address - Street 1:10015 KINGS PARADE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-5718
Practice Address - Country:US
Practice Address - Phone:757-812-3102
Practice Address - Fax:757-812-3102
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72969164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse