Provider Demographics
NPI:1407280761
Name:BREWER, SHATANIE MARIE
Entity type:Individual
Prefix:DR
First Name:SHATANIE
Middle Name:MARIE
Last Name:BREWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 COPLEY RD
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-2111
Mailing Address - Country:US
Mailing Address - Phone:234-334-0185
Mailing Address - Fax:330-681-1496
Practice Address - Street 1:2801 COPLEY RD
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-2111
Practice Address - Country:US
Practice Address - Phone:234-334-0185
Practice Address - Fax:234-278-1407
Is Sole Proprietor?:No
Enumeration Date:2013-08-22
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372500000X, 374U00000X, 171000000X
OH374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No372500000XNursing Service Related ProvidersChore Provider
No374J00000XNursing Service Related ProvidersDoula
No374U00000XNursing Service Related ProvidersHome Health Aide