Individual
TANYA L BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2002016320
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174707001
—
AR
05
—
1851541486
—
MO
01
—
431560263
TRICARE WEST
—
01
—
P00653951
RAILROAD MEDICARE
—
Enumeration date
09/19/2008
Last updated
03/17/2018
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