Individual
DANIEL CLAYTON BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3458
(260) 481-2700
(260) 481-2838
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3458
(260) 481-2700
(260) 481-2838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28193276A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71009110A
IN
Other
Enumeration date
06/27/2019
Last updated
07/08/2019
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