MEDICARE: SIMONE BROOKER-JOLIVETTE

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	363LA2200X	Adult Health Nurse Practitioner	805542	NY
2	363LA2200X	Adult Health Nurse Practitioner	840451	NV

General Provider Information

NPI Number	:	1962357210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONE BROOKER-JOLIVETTE

Provider Business Mailing Address
First Line	:	9929 MARKHORN CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-3741
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7373 PEAK DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9003
Country	:	US
Telephone Number	:	725-780-4351
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ SIMONE BROOKER-JOLIVETTE ” Practice Location

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