Healthcare Provider Details

I. General information

NPI: 1962336859
Provider Name (Legal Business Name): ANGELA BREWER MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA GABBARD

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BELMONT AVE
SOMERSET KY
42501-2419
US

IV. Provider business mailing address

200 BELMONT AVE
SOMERSET KY
42501-2419
US

V. Phone/Fax

Practice location:
  • Phone: 606-687-2038
  • Fax: 606-200-3654
Mailing address:
  • Phone: 606-687-2038
  • Fax: 606-200-3654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4061884
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: