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General NPI Number Information
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NPI Number | 1558701029
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Entity Type | Individual
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Provider Name | LORIE BREWSTER NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 09/09/2016
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Provider Practice Location Address
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Address Line | 21471 N LAKE PLEASANT PKWY
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City | PEORIA
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State | AZ
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Zip | 85382-0001
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Country | US
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Telephone | 623-362-1971
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Fax | 623-362-1962
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Provider Business Mailing Address
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Address Line | 21471 N LAKE PLEASANT PKWY
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City | PEORIA
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State | AZ
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Zip | 85382-0001
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Country | US
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Telephone | 623-362-1971
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Fax | 623-362-1962
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP4984
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License Number State | AZ
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