Individual
MRS. DIANE ELIZABETH BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.P
Contact information
Practice address
1 MEDICAL DR, SUITE 100, PARAGOULD, AR 72450-4017
(870) 239-8503
(870) 236-1947
Mailing address
1 MEDICAL DR, SUITE 100, PARAGOULD, AR 72450-4017
(870) 239-8503
(870) 236-1947
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
R13386
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
770246558
BREASTCARE PROGRAM
AR
Enumeration date
08/07/2008
Last updated
08/07/2008
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