Provider Demographics
NPI:1700461290
Name:ENDERLE, BROOKE GARVEY (PA-C)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:GARVEY
Last Name:ENDERLE
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2601 ANNAND DR STE 4
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-3719
Mailing Address - Country:US
Mailing Address - Phone:302-998-3334
Mailing Address - Fax:302-998-8985
Practice Address - Street 1:2601 ANNAND DR STE 4
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-3719
Practice Address - Country:US
Practice Address - Phone:029-983-3343
Practice Address - Fax:302-998-8985
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-08-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant