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General NPI Number Information
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NPI Number | 1811859549
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Entity Type | Individual
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Provider Name | COURTNEY LYNN BREWSTER
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Gender | Female
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 5030 N WALNUT ST
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City | SOUTH BLOOMFIELD
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State | OH
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Zip | 43103-1018
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Country | US
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Telephone | 740-983-0015
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Fax |
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Provider Business Mailing Address
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Address Line | 1374 W 6TH AVE
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City | COLUMBUS
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State | OH
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Zip | 43212-2406
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Country | US
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Telephone |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APRN.CNP.0038611
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License Number State | OH
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