Individual
MRS. KARIN KAY BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP
Contact information
Practice address
1319 SUMMIT AVE, FORT WORTH, TX 76102-4431
(817) 569-5050
Mailing address
100 N LAMAR ST, FORT WORTH, TX 76102-1954
(817) 884-3229
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
723109
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
331835401
—
TX
01
—
331835402
MEDICAID CSHCN NUMBER
—
01
—
341974YRK5
MEDICARE
—
01
—
8206NJ
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/14/2013
Last updated
09/26/2017
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