Provider Demographics
NPI:1215602412
Name:MONTES, BROOKE NICHOLE (FNP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:NICHOLE
Last Name:MONTES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:NICHOLE
Other - Last Name:MONTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:14333 CARIBE ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6010
Mailing Address - Country:US
Mailing Address - Phone:361-510-9726
Mailing Address - Fax:
Practice Address - Street 1:120 E BEAUREGARD AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5919
Practice Address - Country:US
Practice Address - Phone:253-658-1511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1048920207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine