Healthcare Provider Details

I. General information

NPI: 1679187389
Provider Name (Legal Business Name): ANGELA D. BREWIN MSN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2020
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 PACIFIC AVE FL 8
ATLANTIC CITY NJ
08401-6713
US

IV. Provider business mailing address

32 WILTON WAY
SICKLERVILLE NJ
08081-9215
US

V. Phone/Fax

Practice location:
  • Phone: 609-572-8241
  • Fax: 609-441-8002
Mailing address:
  • Phone: 856-261-0083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ01021800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: