Healthcare Provider Details

I. General information

NPI: 1376244665
Provider Name (Legal Business Name): VALERIE MICHELLE BREWER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2023
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 N WOLFE ST
BALTIMORE MD
21205-1113
US

IV. Provider business mailing address

3123 WEAVER AVE
BALTIMORE MD
21214-3434
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-3250
  • Fax:
Mailing address:
  • Phone: 602-999-0921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR229800
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: