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General NPI Number Information
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NPI Number | 1750754271
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Entity Type | Individual
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Provider Name | KEELIE L BREWER NP
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Gender | Female
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Dates
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Enumeration Date | 11/05/2015
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 1325 SPRING ST
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City | GREENWOOD
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State | SC
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Zip | 29646-3860
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Country | US
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Telephone | 864-725-4095
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Fax | 864-725-5082
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Provider Business Mailing Address
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Address Line | 21 STAR RD
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City | EDGEFIELD
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State | SC
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Zip | 29824-4209
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Country | US
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Telephone | 803-275-6130
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 102511
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 23500
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License Number State | SC
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