Healthcare Provider Details

I. General information

NPI: 1154694909
Provider Name (Legal Business Name): DR CHERYL ANN BREWER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2931 N TENAYA WAY STE 202
LAS VEGAS NV
89128-0458
US

IV. Provider business mailing address

2931 N TENAYA WAY STE 202
LAS VEGAS NV
89128-0458
US

V. Phone/Fax

Practice location:
  • Phone: 702-410-5822
  • Fax: 702-485-5018
Mailing address:
  • Phone: 702-410-5822
  • Fax: 702-485-5018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number12923
License Number StateNV

VIII. Authorized Official

Name: CHERYL ANN BREWER
Title or Position: PRESIDENT
Credential: MD
Phone: 702-410-5822