Individual
TANITA COTTON BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6125 ASCOT WAY, COLUMBUS, GA 31909-3609
(678) 993-6366
Mailing address
6125 ASCOT WAY, COLUMBUS, GA 31909-3609
(678) 993-6366
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN057209
GA
Other
Enumeration date
09/10/2025
Last updated
09/10/2025
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