Brewer, Kacie June

Brewer, Kacie June is an individual health care provider with primary practice located at 4500 San Pablo Rd S , Jacksonville FL 32224-1865. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Brewer, Kacie June can be contacted via phone (904) 953-2000.

Contact Information

Primary practice address
4500 San Pablo Rd S Jacksonville FL 32224-1865
Phone: (904) 953-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 0110005142 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9107527 Florida

Profile Details

NPI number 1639506199
LBN Legal business name Brewer, Kacie June
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2013
Last updated Nov 22nd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639506199 NPPES
Georgia MEDICAID 003140599B
Georgia MEDICAID 003140599A
Georgia MEDICAID 009664700

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