Kellie A Brewer, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN097932 Issued in OH

Practice address

135 East James Street
Bradford, OH 45308

Phone

(937) 448-2097

NPI assigned

May 1, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073734620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 EAST JAMES STREET",
            "city": "BRADFORD",
            "state": "OH",
            "postal_code": "45308",
            "telephone_number": "937-448-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 EAST JAMES STREET",
            "city": "BRADFORD",
            "state": "OH",
            "postal_code": "45308",
            "telephone_number": "937-448-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "KELLIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN097932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2383639",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Beck, M.A. CF-SLP
• Stephanie Beisner, ATC
• Breanna Lee Bixler
• Bradford Exempted Village School District
• Bradford Fire and Rescue Services Inc.
• April J Browning
• Courtney Drees
• Family Health Services of Darke County, Inc.
• Family Health Services of Darke County, Inc.
• Kristie Marie Freeman, LPN

• Licensed Practical Nurse in Bradford, OH
• Providers in Bradford, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.