Provider Demographics
NPI:1598032724
Name:BREE, BROOKE E (CNP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:E
Last Name:BREE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:E
Other - Last Name:GILLESPIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNP
Mailing Address - Street 1:3406 BOB ROGERS DR STE 250
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5942
Mailing Address - Country:US
Mailing Address - Phone:830-757-4900
Mailing Address - Fax:
Practice Address - Street 1:3406 BOB ROGERS DR STE 250
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5942
Practice Address - Country:US
Practice Address - Phone:830-757-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1129731363LF0000X
OH12831363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201132030Medicaid
OH0066512Medicaid
KY7100219870Medicaid
KYK043890Medicare PIN
IN201132030Medicaid