MEDICARE: MRS. NORA LYNN BREWSTER MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801082618	MI

General Provider Information

NPI Number	:	1043359409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NORA LYNN BREWSTER MSW

Provider Business Mailing Address
First Line	:	8716 N BOOT LAKE RD
Second Line	:
City	:	MANISTIQUE
State	:	MI
Zip	:	49854
Country	:	US
Telephone Number	:	906-452-6233
Fax Number	:	906-452-6233

Provider Business Practice Location Address
First Line	:	8716 N BOOT LAKE RD
Second Line	:
City	:	MANISTIQUE
State	:	MI
Zip	:	49854
Country	:	US
Telephone Number	:	906-452-6233
Fax Number	:	906-452-6233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/08/2007

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