Individual
LINDA BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
610 SECOND ST, PELAHATCHIE, MS 39145-3135
(601) 854-5044
(601) 854-8448
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R544787
MS
363LG0600X
Gerontology Nurse Practitioner
R544787
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114606
—
MS
Enumeration date
06/09/2006
Last updated
02/26/2019
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