Provider Demographics
NPI:1659877827
Name:KNOP, BROOKE L (CNM)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:L
Last Name:KNOP
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:L
Other - Last Name:POSEGATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 PLEASANT STREET
Mailing Address - Street 2:SOUTH 2 ROOM 236
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1406
Mailing Address - Country:US
Mailing Address - Phone:515-241-6228
Mailing Address - Fax:515-241-8685
Practice Address - Street 1:3714 INGERSOLL AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-3411
Practice Address - Country:US
Practice Address - Phone:515-309-6011
Practice Address - Fax:515-309-6014
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB137679367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife