Healthcare Provider Details

I. General information

NPI: 1932834256
Provider Name (Legal Business Name): BROOKE LAUREN MENEFEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 KINKAID RD
ANNAPOLIS MD
21402-1006
US

IV. Provider business mailing address

1804 HAMPTON CHASE CT
PASADENA MD
21122-3535
US

V. Phone/Fax

Practice location:
  • Phone: 410-293-2009
  • Fax:
Mailing address:
  • Phone: 443-848-1291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberR206448
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: