Provider Demographics
NPI:1376256115
Name:HAUBRICK, BROOKE LEEANN (CRNP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:LEEANN
Last Name:HAUBRICK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-1251
Mailing Address - Country:US
Mailing Address - Phone:717-513-6354
Mailing Address - Fax:
Practice Address - Street 1:449 SUMMIT DR
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1251
Practice Address - Country:US
Practice Address - Phone:717-513-6354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026861363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology