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NPI Code Detail

MEDICARE: SHANNON KRISTINE BROOKS APRN, NNP-BC

MEDICARE: SHANNON KRISTINE BROOKS APRN, NNP-BC
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
1363LN0000XNeonatal Nurse Practitioner597062TX
2163WN0002XNeonatal Intensive Care Registered Nurse597062TX

General Provider Information

NPI Number : 1912968157
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON KRISTINE BROOKS APRN, NNP-BC
Provider Business Mailing Address
First Line : 1301 CONCORD TER
Second Line :
City : SUNRISE
State : FL
Zip : 33323-2843
Country : US
Telephone Number : 800-243-3839
Fax Number :
Provider Business Practice Location Address
First Line : 1301 CONCORD TER
Second Line :
City : SUNRISE
State : FL
Zip : 33323-2843
Country : US
Telephone Number : 800-243-3839
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 04/13/2022

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