Healthcare Provider Details

I. General information

NPI: 1326586637
Provider Name (Legal Business Name): BROOKE RACHELLE BRIGGS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2017
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 E 2ND ST
GRAINFIELD KS
67737-3505
US

IV. Provider business mailing address

123 E 2ND ST
GRAINFIELD KS
67737-3505
US

V. Phone/Fax

Practice location:
  • Phone: 785-953-5953
  • Fax:
Mailing address:
  • Phone: 785-953-5953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number116292
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-82381-102
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: