BROOKE WILLETTE (NPI# 1174058291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174058291 |
| Entity Type | Individual |
| Full Name | BROOKE WILLETTE |
| Practice Address |
18210 N 92nd Ln Peoria AZ 85382-7707 |
| Practice Telephone | 6024108196 |
| Mailing Telephone | 6024108196 |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-04-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
18210 N 92ND LN |
| City | PEORIA |
| State | AZ |
| Zip Code | 85382-7707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205435146 | Arizona Ot Solutions LLC | Occupational Therapist | 7450 W. Karen Lee Lane, Peoria, AZ 85382 | 2020-10-21 |
| 1497380604 | Idream Psychiatry | Psychiatry & Neurology | 8194 West Deer Valley Rd, 106-516, Peoria, AZ 85382 | 2020-03-08 |
| 1770137648 | Stefan Cseh | Occupational Therapy Assistant | 8765 W Keiton Lane #116, Peona, AZ 85382 | 2019-07-30 |
| 1174177422 | Assyrian Cultural Foundation of Arizona | Homemaker | 9163 West Union Hills Drive, Suite 114 and 115, Peoria, AZ 85382 | 2019-07-25 |
| 1073072765 | Darby Shipman | Physical Therapist | 8685 W. Union Hills Drive, Peoria, AZ 85382 | 2019-03-13 |
| 1811483480 | Kimberly Ann Cochran | Nurse Practitioner | 8194 W Deer Valley Rd Ste 106-516, Peoria, AZ 85382 | 2018-07-07 |
| 1831693514 | Summa Health Care, PC | Family Medicine | 8877 W Union Hills Dr Ste 240, Peoria, AZ 85382 | 2018-03-19 |
| 1497258727 | Nkemdirim Obiora | Nurse Practitioner | 7853 West Lone Cactus Drive, Peoria, AZ 85382 | 2018-03-13 |
| 1851893721 | Alyssa Michelle Bauman | Registered Nurse | 20283 N Lake Pleasant Rd Ste 112, Peoria, AZ 85382 | 2018-03-06 |
| 1043767106 | Jason Mcaddley | Pharmacist | 9425 West Union Hills Drive, Peoria, AZ 85382 | 2016-09-07 |
| Find all providers in zip 85382 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821609751 | Amanda Ferreira | Student in an Organized Health Care Education/Training Program | 7421 W Shangri La Rd, Peoria, AZ 85345-5811 | 2020-08-13 |
| 1699396838 | Ashif Khaled Molla | Student in an Organized Health Care Education/Training Program | Osf St Francis Medical Center 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-04-28 |
| 1437779063 | Mena Henien | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave Bldg 5676, Peoria, IL 61637-0001 | 2020-04-23 |
| 1306465893 | Sarath Kumar Jaganathan Jaishankar | Student in an Organized Health Care Education/Training Program | 530 Ne Glenn Oak Avenue, Peoria, IL 61637-0001 | 2020-04-14 |
| 1952920522 | Phu Si Huynh | Student in an Organized Health Care Education/Training Program | 331 Fulton St Apt 302, Peoria, IL 61602-1436 | 2020-04-13 |
| 1730736604 | Gabriela C Isenia | Student in an Organized Health Care Education/Training Program | 9031 W Tonopah Dr, Peoria, AZ 85382-6445 | 2019-08-24 |
| 1831751643 | Noreen Khan | Student in an Organized Health Care Education/Training Program | 1501 W Coneflower Dr Apt 2212, Peoria, IL 61615-7465 | 2019-07-01 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.