Odelia Brew

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

12.006638 Issued in CT

Practice address

378 Main St
Manchester, CT 06042-6514

Phone

(860) 335-4397

Fax

(860) 469-2322

NPI assigned

Apr 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Odelia Baah Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Trusted Angels Health Services LLC

  • Home Health Agency
  • Manchester, CT
  • NPI 1871294892
  NPD Authorized official

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1962856179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060426514",
            "telephone_number": "860-335-4397",
            "fax_number": "860-792-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060426514",
            "telephone_number": "860-335-4397",
            "fax_number": "860-469-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREW",
        "first_name": "ODELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-14",
        "last_updated": "2024-07-03",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "12.006638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ODELIA",
            "last_name": "BAAH",
            "credential": "APRN, NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Break Free Center for Wellness
• Breakaway Health Services LLC
• Brianna Breen
• Meredtih M Brennan
• Shirley Elizabeth Breuer
• Shontelle Brewster, LMFT-A
• Jayla Charllette Bridges, LMSW
• Michael A Briscoe, CLINICAL THERAPIST
• Stephanie Marie Brito
• Jenna Nicole Britton, LMSW

• Primary Care Nurse Practitioner in Manchester, CT
• Providers in Manchester, CT by specialty
• Primary Care Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.