Provider Demographics
NPI:1972229169
Name:WIMBERLEY, BROOKE ALISON (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ALISON
Last Name:WIMBERLEY
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 DEER CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-8408
Mailing Address - Country:US
Mailing Address - Phone:386-546-9776
Mailing Address - Fax:
Practice Address - Street 1:1667 N CLYDE MORRIS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5500
Practice Address - Country:US
Practice Address - Phone:386-546-9776
Practice Address - Fax:386-274-2215
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020307363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily