Provider Demographics
NPI:1356938583
Name:PIATT, BROOKEANA RENEE (PA-C)
Entity type:Individual
Prefix:
First Name:BROOKEANA
Middle Name:RENEE
Last Name:PIATT
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1221 CONRAD HILTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CISCO
Mailing Address - State:TX
Mailing Address - Zip Code:76437-3836
Mailing Address - Country:US
Mailing Address - Phone:325-660-6846
Mailing Address - Fax:
Practice Address - Street 1:950 N 19TH ST STE 200
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2420
Practice Address - Country:US
Practice Address - Phone:325-670-5320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant