Provider Demographics
NPI:1851521702
Name:BAJDEK, BROOKE A (RN)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:A
Last Name:BAJDEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-3220
Mailing Address - Country:US
Mailing Address - Phone:512-334-4411
Mailing Address - Fax:512-334-4465
Practice Address - Street 1:1121 E 7TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3220
Practice Address - Country:US
Practice Address - Phone:512-334-4411
Practice Address - Fax:512-334-4465
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX588469163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse