Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 128792 | CT |
N | 363LP2300X | Nurse Practitioner - Primary Care | 7717 | CT |
NPI | 1063904407 |
---|---|
Provider Name | Peter Nicholas Brehmer |
First Address | Fairfield, CT 06825-4401 |
Second Address | Sheppard Afb, TX 76311-1397 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2018 |
Last Update Date | 30/01/2022 |