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General NPI Number Information
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NPI Number | 1972985554
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Entity Type | Individual
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Provider Name | BROOKE ELIZABETH NYMAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/19/2015
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 200 HYGEIA DR
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City | NEWARK
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State | DE
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Zip | 19713-2049
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Country | US
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Telephone | 302-273-1701
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Fax | 302-273-4497
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Provider Business Mailing Address
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Address Line | 1800 E PARK AVE
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City | STATE COLLEGE
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State | PA
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Zip | 16803-6701
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Country | US
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Telephone | 814-234-6110
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0012263
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA057682
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License Number State | PA
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