Provider Demographics
NPI:1487337259
Name:LANDIS, BROOKE ELIZABETH (APRN-CNP)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ELIZABETH
Last Name:LANDIS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:ELIZABETH
Other - Last Name:WIGAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:4301 W 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-1750
Mailing Address - Country:US
Mailing Address - Phone:719-352-1814
Mailing Address - Fax:
Practice Address - Street 1:6895 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3047
Practice Address - Country:US
Practice Address - Phone:303-861-7878
Practice Address - Fax:303-894-8066
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0102190363LF0000X, 363LF0000X
TX1130404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily