Provider Demographics
NPI:1780274829
Name:MICHAEL, BROOKE ASHLEY (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ASHLEY
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:MISS
Other - First Name:BROOKE
Other - Middle Name:ASHLEY
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:179 PLEASANT POINT DR
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1117
Mailing Address - Country:US
Mailing Address - Phone:330-428-4187
Mailing Address - Fax:
Practice Address - Street 1:182 SEA ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:LADYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29907-1503
Practice Address - Country:US
Practice Address - Phone:843-322-1933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily