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General NPI Number Information
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NPI Number | 1700407012
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Entity Type | Individual
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Provider Name | BROOKE UNDERBRINK RN
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Gender | Female
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 04/28/2020
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Provider Practice Location Address
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Address Line | 7307 S REVERE PKWY STE 200
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City | CENTENNIAL
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State | CO
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Zip | 80112-3931
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Country | US
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Telephone | 303-355-4745
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 DAILY DR
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City | ERIE
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State | CO
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Zip | 80516-7232
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Country | US
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Telephone | 303-775-2221
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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 | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 0174919
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License Number State | CO
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