| NPI | 1578238283 |
|---|---|
| Former Name | BROOKE LEEANN COLCLASURE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1050527) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1050527) |
| Enumeration Date | 2021-08-13 |
| Last Update Date | 2024-08-30 |