Healthcare Provider Details

I. General information

NPI: 1154403749
Provider Name (Legal Business Name): SHAWN BROOKING CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 E 23RD ST
PANAMA CITY FL
32405-4501
US

IV. Provider business mailing address

103 E 23RD ST
PANAMA CITY FL
32405-4501
US

V. Phone/Fax

Practice location:
  • Phone: 850-769-0338
  • Fax: 850-640-2195
Mailing address:
  • Phone: 850-769-0338
  • Fax: 850-785-6088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN9375289
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPRN9375289
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: