Provider Demographics
NPI:1912780487
Name:DOOLEY, BROOKE ROSE (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ROSE
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:BALO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:3346 DOTHAN LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-3842
Mailing Address - Country:US
Mailing Address - Phone:714-716-9876
Mailing Address - Fax:
Practice Address - Street 1:4909 W PARK BLVD STE 177
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-2311
Practice Address - Country:US
Practice Address - Phone:972-955-2263
Practice Address - Fax:972-521-3215
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX872828363LF0000X
TXF10210229363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily