Provider Demographics
NPI:1861972358
Name:LOVELESS-YATES, BROOKE DIANE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:DIANE
Last Name:LOVELESS-YATES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 PETER BRYCE BLVD
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-7457
Mailing Address - Country:US
Mailing Address - Phone:205-348-1770
Mailing Address - Fax:
Practice Address - Street 1:2371 HIGHWAY 78
Practice Address - Street 2:
Practice Address - City:DORA
Practice Address - State:AL
Practice Address - Zip Code:35062-5233
Practice Address - Country:US
Practice Address - Phone:205-255-7052
Practice Address - Fax:205-255-7053
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-111217363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily