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General NPI Number Information
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NPI Number | 1386110708
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Entity Type | Individual
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Provider Name | JAMIE THERSE BREWER APRN-CS
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Gender | Female
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Dates
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Enumeration Date | 10/24/2018
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1401 E STATE ST FL 4
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City | ROCKFORD
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State | IL
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Zip | 61104-2315
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Country | US
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Telephone | 779-696-4123
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Fax |
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Provider Business Mailing Address
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Address Line | 2560 24TH ST STE 101
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City | ROCK ISLAND
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State | IL
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Zip | 61201-5389
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Country | US
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Telephone | 309-779-3970
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 309013502
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 209018120
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 377002908
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number | 309.013502
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License Number State | IL
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