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General NPI Number Information
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NPI Number | 1861225666
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Entity Type | Individual
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Provider Name | MICHELLE LEAVETHA BROOKS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/26/2024
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 14400 CLAYTON RD
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City | BALLWIN
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State | MO
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Zip | 63011-2713
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Country | US
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Telephone | 866-389-2727
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Fax | 256-827-5084
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Provider Business Mailing Address
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Address Line | 14400 CLAYTON RD
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City | BALLWIN
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State | MO
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Zip | 63011-2713
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Country | US
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Telephone | 866-389-2727
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Fax | 256-827-5084
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2025027141
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 140862
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 231027
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License Number State | AK
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