Doctor Name: | BROOKE ANN MANUEL |
NPI Number: | 1265796676 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 694390 |
Business Practice Address: | 801 Montgomery St Port Neches, TX - 776512328 |
Business Phone Number: | 4093440702 |
Business Fax Number: | |
Mailing Address: | 801 Montgomery St, PORT NECHES |
State: | TX |
Postal Code: | 776512328 |
Phone Number: | 4093440705 |
Fax Number: | |
NPI Enumeration Date: | 06/29/2012 |
NPI Last Update Date: | 06/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 694390 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |