Provider Demographics
NPI:1073078713
Name:HAYES, BROOKE DEE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:DEE
Last Name:HAYES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:BROOKE
Other - Middle Name:DEE
Other - Last Name:HAVLAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2117 S 113TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3023
Mailing Address - Country:US
Mailing Address - Phone:402-525-1338
Mailing Address - Fax:
Practice Address - Street 1:10802 FARNAM DR STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-3200
Practice Address - Country:US
Practice Address - Phone:402-686-2809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23461183500000X
NE16117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist