Provider Demographics
NPI:1700127388
Name:BREWER, JENNIFER DENISE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:DENISE
Last Name:BREWER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:DENISE
Other - Last Name:CARLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:110 SAINT BLAISE RD STE 200
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-4594
Practice Address - Country:US
Practice Address - Phone:615-230-8070
Practice Address - Fax:615-452-1774
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4363363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant