Healthcare Provider Details

I. General information

NPI: 1790258358
Provider Name (Legal Business Name): BROOKE ADAMS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2019
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 BAKER AVE
WHITEFISH MT
59937-2901
US

IV. Provider business mailing address

1111 BAKER AVE
WHITEFISH MT
59937-2901
US

V. Phone/Fax

Practice location:
  • Phone: 406-862-2515
  • Fax: 406-862-4229
Mailing address:
  • Phone: 406-862-2515
  • Fax: 406-862-4229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number143096
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: