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General NPI Number Information
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NPI Number | 1366326597
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Entity Type | Individual
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Provider Name | BROOKE ELIZABETH NOVAK
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Gender | Female
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 4801 E LINWOOD BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64128-2226
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Country | US
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Telephone | 516-861-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 18418 OLD BB
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City | HOLT
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State | MO
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Zip | 64048-8746
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Country | US
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Telephone | 540-230-9589
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2025032728
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License Number State | MO
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