MEDICARE: BROOKE ELIZABETH BRASFIELD APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	220280	OK

General Provider Information

NPI Number	:	1699592196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE ELIZABETH BRASFIELD APRN, FNP-C

Provider Business Mailing Address
First Line	:	932 W 13TH ST
Second Line	:
City	:	ATOKA
State	:	OK
Zip	:	74525-3425
Country	:	US
Telephone Number	:	580-889-2116
Fax Number	:	580-889-7698

Provider Business Practice Location Address
First Line	:	932 W 13TH ST
Second Line	:
City	:	ATOKA
State	:	OK
Zip	:	74525-3425
Country	:	US
Telephone Number	:	580-889-2116
Fax Number	:	580-889-7698

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2024
Last Update Date	:	09/25/2024

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