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NPI Code Detail

MEDICARE: PATRICIA LYNN BREWER P.A.-C

MEDICARE: PATRICIA LYNN BREWER P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant75538MT

General Provider Information

NPI Number : 1003901216
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA LYNN BREWER P.A.-C
Provider Business Mailing Address
First Line : 29148 HWY 200 E
Second Line :
City : BONNER
State : MT
Zip : 59823-9541
Country : US
Telephone Number : 406-901-0106
Fax Number :
Provider Business Practice Location Address
First Line : 2415 S CATLIN ST
Second Line :
City : MISSOULA
State : MT
Zip : 59801-7822
Country : US
Telephone Number : 406-549-0267
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 04/14/2023

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