Healthcare Provider Details

I. General information

NPI: 1144825266
Provider Name (Legal Business Name): BROOKE NEWMAN CPNP - AC/PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BROOKE BISHIR

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 MUELLER BLVD
AUSTIN TX
78723-3051
US

IV. Provider business mailing address

2000 E 22ND ST UNIT 1
AUSTIN TX
78722-2422
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-0000
  • Fax:
Mailing address:
  • Phone: 260-403-8649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9542397
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number1126183
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: