Provider Demographics
NPI:1912561739
Name:BROOKS, SHELBY R (APRN)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:R
Last Name:BROOKS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:R
Other - Last Name:GRITTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 SW LANE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2550
Mailing Address - Country:US
Mailing Address - Phone:785-233-0500
Mailing Address - Fax:785-233-0660
Practice Address - Street 1:920 SW LANE ST STE 200
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2550
Practice Address - Country:US
Practice Address - Phone:785-233-0500
Practice Address - Fax:785-233-0660
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78772363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner