Provider Demographics
NPI:1578451696
Name:BREWER, GENNA (RN)
Entity type:Individual
Prefix:
First Name:GENNA
Middle Name:
Last Name:BREWER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 W DONNIES DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-6710
Mailing Address - Country:US
Mailing Address - Phone:919-376-6806
Mailing Address - Fax:
Practice Address - Street 1:152 W DONNIES DR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-6710
Practice Address - Country:US
Practice Address - Phone:919-376-6806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC368654163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical