Provider Demographics
NPI:1386639292
Name:FRENCH, BROOKE JOY (APRN)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:JOY
Last Name:FRENCH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5471 DR MARTIN LUTHER KING DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-4265
Mailing Address - Country:US
Mailing Address - Phone:314-367-5820
Mailing Address - Fax:314-367-7010
Practice Address - Street 1:51 N ELM ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1545
Practice Address - Country:US
Practice Address - Phone:203-574-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3690P363LP0200X
MO137261363LP0200X
CT7527363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO78006822Medicaid
KY000000209807OtherID BLUE CROSS INSURANCE
KY20010278OtherPASSPORT NON-PARTICIPATE
KY78006822Medicaid
KY000000209807OtherID BLUE CROSS INSURANCE
KY78006822Medicaid