Individual
JODEE LYNN BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2500
Mailing address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R037994
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0140070
MEDICAID - INPATIENT
SD
05
—
5549050
—
SD
Enumeration date
12/08/2009
Last updated
09/21/2021
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