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1629597851

NPI Code Detail

MEDICARE: BROOKE TAYLOR ERIKSEN MOT, OTR/L

MEDICARE: BROOKE TAYLOR ERIKSEN MOT, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	08225	MD
2	225X00000X	Occupational Therapist	OC015113	PA
3	225X00000X	Occupational Therapist	0119007473	VA
4	225X00000X	Occupational Therapist	13284	NC

General Provider Information

NPI Number	:	1629597851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE TAYLOR ERIKSEN MOT, OTR/L

Provider Business Mailing Address
First Line	:	6046 BERANEK CIR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28543-1407
Country	:	US
Telephone Number	:	570-972-7201
Fax Number	:

Provider Business Practice Location Address
First Line	:	2994 OLD AIRPORT RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-8738
Country	:	US
Telephone Number	:	252-672-8680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2017
Last Update Date	:	10/20/2021

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Directions to “ BROOKE TAYLOR ERIKSEN MOT, OTR/L” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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