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General NPI Number Information
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NPI Number | 1962955807
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Entity Type | Individual
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Provider Name | BROOKE GELECKI NP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 150 N ROADRUNNER PKWY
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City | LAS CRUCES
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State | NM
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Zip | 88011-7044
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Country | US
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Telephone | 575-556-6440
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Fax | 575-556-6445
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Provider Business Mailing Address
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Address Line | 150 N ROADRUNNER PKWY
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City | LAS CRUCES
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State | NM
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Zip | 88011-7044
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Country | US
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Telephone | 575-556-6440
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Fax | 755-566-4455
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CNP-03466
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License Number State | NM
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