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Individual

MR. TERRY RAY BREWER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
3024 STADIUM BLVD, JONESBORO, AR 72401-7415
(501) 227-0700
(501) 227-0744
Mailing address
PO BOX 55990, LITTLE ROCK, AR 72215-5990
(501) 227-0700
(501) 227-0744

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R54097
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C02664
AR

Other

Enumeration date
07/20/2007
Last updated
07/20/2007
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