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General NPI Number Information
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NPI Number | 1619184934
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Entity Type | Individual
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Provider Name | BROOKE K PETERSON PMHNP
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 7230 ARBUCKLE COMMONS STE 243
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City | BROWNSBURG
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State | IN
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Zip | 46112
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Country | US
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Telephone | 317-649-2814
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Fax | 828-374-1540
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Provider Business Mailing Address
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Address Line | 124 E NORTHFIELD DR STE F, #293
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City | BROWNSBURG
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State | IN
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Zip | 46112
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Country | US
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Telephone | 317-649-2814
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Fax | 828-374-1540
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 28164171A
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License Number State | IN
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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 | 71006558A
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License Number State | IN
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