Healthcare Provider Details

I. General information

NPI: 1588148977
Provider Name (Legal Business Name): KIMI LYNN BREWER RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 CHESTER AVE
BAKERSFIELD CA
93301-2012
US

IV. Provider business mailing address

2531 CHESTER AVE
BAKERSFIELD CA
93301-2012
US

V. Phone/Fax

Practice location:
  • Phone: 661-337-7156
  • Fax:
Mailing address:
  • Phone: 661-337-7156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number24301
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: