Healthcare Provider Details

I. General information

NPI: 1548290497
Provider Name (Legal Business Name): LINDA JEAN BREWSTER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/23/2023
Certification Date: 07/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 OLD GRAY RD
CUMBERLAND ME
04021-3009
US

IV. Provider business mailing address

23 OLD GRAY RD
CUMBERLAND ME
04021-3009
US

V. Phone/Fax

Practice location:
  • Phone: 207-807-2210
  • Fax: 207-679-0271
Mailing address:
  • Phone: 207-807-2210
  • Fax: 207-679-0271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP81228
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: