Melissa Ann Brewer, RN

Individual provider Active NPI Case Manager/Care Coordinator · SLC, UT

NPI 1720355100 · NPPES record last updated Nov 29, 2011

Key facts

NPI
1720355100
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
60445733102 (UT)
Practice address
650 Komas Dr
200
SLC, UT 84108-1215
Phone
(801) 587-3855
Fax
(801) 581-7989
NPI assigned
Nov 29, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
60445733102UTMDCase Manager/Care Coordinator

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 60445733102 UT Yes

Addresses

Primary practice location

650 Komas Dr
200
SLC, UT 84108-1215

Mailing address

650 Komas Dr
200
SLC, UT 84108-1215
Phone (801) 587-3855

Other providers in SLC, UT

All providers in SLC, UT · Case Manager/Care Coordinator in Utah

Sources for this page

Verify at the official NPI Registry.