Individual
JAY R BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
105 E LOCUST ST, BLOOMFIELD, IA 52537-1458
(641) 664-3602
(641) 664-3765
Mailing address
PO BOX 54, BLOOMFIELD, IA 52537-0054
(641) 664-3602
(641) 664-3765
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D099449
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0206177
—
IA
01
—
16605
BCBS
IA
01
—
430059427
RAILROAD MEDICARE
—
Enumeration date
08/30/2006
Last updated
03/06/2012
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