1295323848 NPI number — MS. BROOKE MCLAIN RN-MSN

Table of content: MS. BROOKE MCLAIN RN-MSN (NPI 1295323848)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295323848 NPI number — MS. BROOKE MCLAIN RN-MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCLAIN
Provider First Name:
BROOKE
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN-MSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCLAIN
Provider Other First Name:
BROOKE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN-MSN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1295323848
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 HILLCAT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILLSBORO
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03244-4847
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-464-1311
Provider Business Mailing Address Fax Number:
603-218-6387

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 HILLCAT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HILLSBORO
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03244-4847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-464-1311
Provider Business Practice Location Address Fax Number:
603-218-6387
Provider Enumeration Date:
01/08/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WS0200X , with the licence number:  068268-21 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)