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General NPI Number Information
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NPI Number | 1235597329
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Entity Type | Individual
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Provider Name | MICHAEL BREWER CRNP
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Gender | Male
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 2360 E PERSHING BLVD
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City | CHEYENNE
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State | WY
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Zip | 82001-5356
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Country | US
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Telephone | 307-778-7550
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Fax |
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Provider Business Mailing Address
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Address Line | 1621 CENTRAL AVE # 56902
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City | CHEYENNE
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State | WY
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Zip | 82001-4531
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Country | US
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Telephone | 307-212-9200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP015910
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 54666
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License Number State | WY
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