Provider Demographics
NPI:1003528639
Name:WEST, BROOKE MICHELLE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:MICHELLE
Last Name:WEST
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8884 W STATE ROAD 32
Mailing Address - Street 2:
Mailing Address - City:FARMLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47340-9127
Mailing Address - Country:US
Mailing Address - Phone:317-517-7269
Mailing Address - Fax:
Practice Address - Street 1:2400 CHATEAU DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-1900
Practice Address - Country:US
Practice Address - Phone:655-781-5017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28223145A163W00000X
IN71013595A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse