Healthcare Provider Details

I. General information

NPI: 1770405045
Provider Name (Legal Business Name): BROOKE WERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BROOKE HUNTER

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 CALHOUN ST
CHARLESTON SC
29425-8906
US

IV. Provider business mailing address

268 CALHOUN ST
CHARLESTON SC
29425-8906
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: