Provider Demographics
NPI:1346686938
Name:RHODES, BROOKE E (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:E
Last Name:RHODES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:E
Other - Last Name:STARCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFNP
Mailing Address - Street 1:1322 PINEVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505
Mailing Address - Country:US
Mailing Address - Phone:304-599-8790
Mailing Address - Fax:304-599-8795
Practice Address - Street 1:1322 PINEVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-599-8790
Practice Address - Fax:304-599-8795
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV78390363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810026344Medicaid
WV3810026344Medicaid