Provider Demographics
NPI:1578051496
Name:BREWER, RYLAND MATTHEW (RN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:RYLAND
Middle Name:MATTHEW
Last Name:BREWER
Suffix:
Gender:M
Credentials:RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 GATE LN APT 309
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-3539
Mailing Address - Country:US
Mailing Address - Phone:423-368-0485
Mailing Address - Fax:865-374-7317
Practice Address - Street 1:1451 DOWELL SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2441
Practice Address - Country:US
Practice Address - Phone:865-970-9800
Practice Address - Fax:865-374-7317
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN36091363LP0808X
TN200741163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse