| NPI | 1295339208 |
|---|---|
| Former Name | BROOKE ELISE HUMPHREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71010968A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28229877A) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2024-12-17 |