Provider Demographics
NPI:1427412485
Name:VARNUM, BROOKE
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:VARNUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8804 RENNER BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1440
Mailing Address - Country:US
Mailing Address - Phone:913-676-8400
Mailing Address - Fax:913-599-1692
Practice Address - Street 1:8804 RENNER BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1440
Practice Address - Country:US
Practice Address - Phone:913-676-8400
Practice Address - Fax:913-599-1692
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0442041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine