Kent Russell Brouwer, APRN
Individual provider Active NPI Acute Care Nurse Practitioner · Lexington, KY
NPI 1972220697 · NPPES record last updated Oct 24, 2022
Key facts
- NPI
- 1972220697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 3018073 (KY)
- Practice address
- 1740 Nicholasville Rd
Lexington, KY 40503-1431 - Phone
- (859) 260-6100
- NPI assigned
- Oct 24, 2022
- Sex
- Male
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3018073 | KY | MD | Acute Care Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 3018073 | KY | Yes |
Addresses
Primary practice location
1740 Nicholasville Rd
Lexington, KY 40503-1431
Mailing address
605 Mitchell Ave
Lexington, KY 40504-3508
Phone (919) 265-3776
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All providers in Lexington, KY · Acute Care Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.