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General NPI Number Information
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NPI Number | 1922525153
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Entity Type | Individual
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Provider Name | BROOKE BASFORD
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Gender | Female
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | PSC 482 BOX 1600
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City | FPO
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State | AP
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Zip | 96362-9998
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Country | US
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Telephone | 850-502-8062
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 1005 BOX 110185
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City | FPO
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State | AA
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Zip | 34009
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Country | US
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Telephone | 757-695-0218
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9283274
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 9283274
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License Number State | FL
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