MEDICARE: BROOKE DEES

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	363LF0000X	Family Nurse Practitioner	903221	MS

General Provider Information

NPI Number	:	1912469156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE DEES

Provider Business Mailing Address
First Line	:	4625 GRASS RIDGE RD
Second Line	:
City	:	MOSS POINT
State	:	MS
Zip	:	39562-7238
Country	:	US
Telephone Number	:	228-219-2206
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720A MEDICAL PARK DR STE 150
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39532-2135
Country	:	US
Telephone Number	:	228-392-7429
Fax Number	:

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

Provider Enumeration Date	:	04/05/2019
Last Update Date	:	04/05/2019

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Directions to “ BROOKE DEES ” Practice Location

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