Provider Demographics
NPI:1134338916
Name:BROOKSHIRE, NANCY CECILE (ACNP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:CECILE
Last Name:BROOKSHIRE
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:CECILE
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7610 N STEMMONS FWY STE 600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4228
Mailing Address - Country:US
Mailing Address - Phone:214-689-5960
Mailing Address - Fax:469-713-8084
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:PAV II, SUITE 630
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:214-941-6891
Practice Address - Fax:214-943-5871
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX544715363L00000X
TXAP110631363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1427759-01Medicaid
TX88N170OtherBCBSTX
TX88N170OtherBCBSTX
TX1427759-01Medicaid
TX500027242Medicare PIN