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General NPI Number Information
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NPI Number | 1891026639
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Entity Type | Individual
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Provider Name | BROOKE W. EISENHART FNP
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Gender | Female
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 1840 E BASELINE RD STE A1
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City | TEMPE
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State | AZ
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Zip | 85283-1527
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Country | US
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Telephone | 480-718-5400
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Fax | 877-666-4624
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Provider Business Mailing Address
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Address Line | PO BOX 308
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-1806
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Country | US
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Telephone | 480-718-5400
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Fax | 877-666-4624
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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 | AP3533
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License Number State | AZ
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