Provider Demographics
NPI:1457872038
Name:CRAFT, BROOKE AMALEA (DNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:AMALEA
Last Name:CRAFT
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:MISS
Other - First Name:BROOKE
Other - Middle Name:AMALEA
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2141 SELWYN AVE APT 113
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-2459
Mailing Address - Country:US
Mailing Address - Phone:704-449-1582
Mailing Address - Fax:
Practice Address - Street 1:444 WILLIAMSON RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9247
Practice Address - Country:US
Practice Address - Phone:704-658-9779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-04
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009644363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty