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General NPI Number Information
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NPI Number | 1053876573
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Entity Type | Individual
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Provider Name | BROOKE THOUVENOT
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Gender | Female
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Dates
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Enumeration Date | 02/08/2019
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 842 N MAIN ST
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City | LANSING
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State | KS
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Zip | 66043-1305
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Country | US
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Telephone | 913-250-5155
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Fax | 913-250-5515
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Provider Business Mailing Address
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Address Line | 715 SOUTHWIND DR
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City | JUNCTION CITY
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State | KS
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Zip | 66441-9021
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Country | US
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Telephone | 785-209-3779
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Fax | 785-209-3780
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 14-133740-051
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2019004291
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 53-80720-051
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 2009026463
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License Number State | MO
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