Provider Demographics
NPI:1346555315
Name:BERING, BROOKE ANN (PA)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ANN
Last Name:BERING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 BALTIMORE BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6128
Mailing Address - Country:US
Mailing Address - Phone:410-751-3840
Mailing Address - Fax:
Practice Address - Street 1:532 BALTIMORE BLVD STE 211
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6128
Practice Address - Country:US
Practice Address - Phone:410-751-3840
Practice Address - Fax:410-751-3874
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004271363AM0700X, 364SM0705X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical