Provider Demographics
NPI:1023747557
Name:ANDERSON, BROOKE M (RN)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:M
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 PRAIRIE GRASS RD
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-3827
Mailing Address - Country:US
Mailing Address - Phone:608-877-6877
Mailing Address - Fax:
Practice Address - Street 1:697 PRAIRIE GRASS RD
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:WI
Practice Address - Zip Code:53575-3827
Practice Address - Country:US
Practice Address - Phone:608-877-6877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI135525-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health