Provider Demographics
NPI:1861083560
Name:ELL, BROOKE ASHLEY (NP-C)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ASHLEY
Last Name:ELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 WOODBINE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-1761
Mailing Address - Country:US
Mailing Address - Phone:812-243-8921
Mailing Address - Fax:
Practice Address - Street 1:670 E MARGARET DR
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-3950
Practice Address - Country:US
Practice Address - Phone:812-232-1410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71010865A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily