Provider Demographics
NPI:1750922324
Name:POWER, BROOKE LYNN (RRT-ACCS)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:LYNN
Last Name:POWER
Suffix:
Gender:F
Credentials:RRT-ACCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 RANCH DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-2574
Mailing Address - Country:US
Mailing Address - Phone:505-819-9306
Mailing Address - Fax:
Practice Address - Street 1:2009 RANCH DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-2574
Practice Address - Country:US
Practice Address - Phone:505-819-9306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered