=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407778087
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ESTELLE ROSE BREWER MS, RDN, CSCS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2026
-----------------------------------------------------
Last Update Date | 07/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 907 COUNTY ROAD 126N
-----------------------------------------------------
City | NEDERLAND
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-888-7412
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2016
-----------------------------------------------------
City | NEDERLAND
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80466-2016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-888-7412
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 86420582
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------