Provider Demographics
NPI:1831636604
Name:MASTEN, BROOKE MILLER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:MILLER
Last Name:MASTEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:MARIE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2475 HILLCREST CENTER CIR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3048
Mailing Address - Country:US
Mailing Address - Phone:336-754-3528
Mailing Address - Fax:336-754-3892
Practice Address - Street 1:2475 HILLCREST CENTER CIR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3048
Practice Address - Country:US
Practice Address - Phone:336-754-3528
Practice Address - Fax:336-754-3892
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24252183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist