Provider Demographics
NPI:1649412636
Name:NAFFZIGER, BROOKE NICHOLE (DO)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:NICHOLE
Last Name:NAFFZIGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:BROOKE
Other - Middle Name:NICHOLE-NAFFZIGER
Other - Last Name:HARMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:146 E HOSPITAL DR STE 240
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169
Practice Address - Country:US
Practice Address - Phone:803-936-7590
Practice Address - Fax:803-936-7589
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN57566207V00000X
MI5101018166207V00000X
SC51928207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty