Healthcare Provider Details

I. General information

NPI: 1215678222
Provider Name (Legal Business Name): BROOKE NICOLE WILKEY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 E ROOSEVELT ST
PHOENIX AZ
85008-4973
US

IV. Provider business mailing address

4001 N 3RD ST STE 290
PHOENIX AZ
85012-2071
US

V. Phone/Fax

Practice location:
  • Phone: 602-266-2733
  • Fax:
Mailing address:
  • Phone: 623-308-2472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number010949
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number010949
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: