Healthcare Provider Details

I. General information

NPI: 1770991978
Provider Name (Legal Business Name): WILLIAM MICHAEL BREWER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10805 DUNDEE RD
KNOXVILLE TN
37934-1814
US

IV. Provider business mailing address

10805 DUNDEE RD
KNOXVILLE TN
37934-1814
US

V. Phone/Fax

Practice location:
  • Phone: 865-789-2172
  • Fax: 865-966-6302
Mailing address:
  • Phone: 865-789-2172
  • Fax: 865-966-6302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number1000000014344
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number1000000014344
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number1000000014344
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number1000000014344
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number1000000014344
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number1000000014344
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number1000000014344
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: