Healthcare Provider Details

I. General information

NPI: 1235810912
Provider Name (Legal Business Name): ASHLEY NICOLE BREW FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 ENTERPRISE DR
AUGUSTA ME
04330-7997
US

IV. Provider business mailing address

15 ENTERPRISE DR
AUGUSTA ME
04330-7997
US

V. Phone/Fax

Practice location:
  • Phone: 207-621-8800
  • Fax: 207-621-8801
Mailing address:
  • Phone: 207-621-8800
  • Fax: 207-621-8801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP251516
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1129823
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: