BROOKE CARLYLE (NPI# 1316430440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316430440 |
| Entity Type | Individual |
| Full Name | BROOKE CARLYLE |
| Credential | APRN, PMHNP |
| Practice Address |
123 Smith Ave Sikeston MO 63801-5239 |
| Practice Telephone | 5734710200 |
| Practice Fax Number | 5734812209 |
| Mailing Telephone | 5734710200 |
| Mailing Fax Number | 5734812209 |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2020-06-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2018019839 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 760 Plantation Blvd, Sikeston, MO 63801 | 5734710800 | |
| 9979 Winghaven Blvd Ste 202, O Fallon, MO 633683628 | 6366954554 |
| Street Address |
123 SMITH AVE |
| City | SIKESTON |
| State | MO |
| Zip Code | 63801-5239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538264072 | Judy Menz | Nurse Practitioner | 123 Smith Ave, Sikeston, MO 63801-5239 | 2006-09-13 |
| 1124629381 | Laura Sternberg | Counselor | 123 Smith Ave, Sikeston, MO 63801-5239 | 2020-11-04 |
| 1508484890 | Kayla Dicus | Nurse Practitioner | 123 Smith Ave, Sikeston, MO 63801-5239 | 2020-07-13 |
| 1174789549 | Missouri Delta Medical Center | Clinic/Center | 123 Smith Ave, Sikeston, MO 63801-5239 | 2008-08-05 |
| 1528247970 | Adonis Enrique Bernardo | Preventive Medicine | 123 Smith Ave, Sikeston, MO 63801-5239 | 2007-11-01 |
| 1063618932 | Laurel Campbell | Internal Medicine | 123 Smith Ave, Sikeston, MO 63801-5239 | 2007-06-26 |
| 1386733830 | Margaret L Dicus | Nurse Practitioner | 123 Smith Ave, Sikeston, MO 63801 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285082 | Logan & Seiler Inc | Pharmacy | 102 Hospitality Drive, Suite B, Sikeston, MO 63801 | 2020-08-11 |
| 1992212153 | Sharaye Gilmore | Social Worker | 135 Plaza Dr Suite 102, Sikeston, MO 63801 | 2018-01-09 |
| 1730606385 | Megan Leann Schlosser | Occupational Therapy Assistant | Kenny Rogers Children's Center, 300 Floyd Dr., Sikeston, MO 63801 | 2017-08-24 |
| 1780130930 | Delta South Adult Care Center LLC | Clinic/Center | 640 Colonel George E Day Parkway, Sikeston, MO 63801 | 2016-08-28 |
| 1013236421 | Missouri Delta Medical Center | Clinic/Center | 1013 North Main, Sikeston, MO 63801 | 2010-05-25 |
| 1134361868 | Sikeston Rehab, LLC | Physical Therapy Assistant | 806 S. Kingshighway, Sikeston, MO 63801 | 2009-03-26 |
| 1508066978 | Paula Kaye Beck | Occupational Therapist | 2016 Oklahoma Ave, Sikeston, MO 63801 | 2007-07-23 |
| 1740497551 | James D West | Audiologist | 903 South Kingshighway, Sikeston, MO 63801 | 2007-05-17 |
| 1619190162 | Syed Muhammad Shahab Sayeed | Psychiatry & Neurology | 1008 N Main, Missouri Delta Medical Centre, Sikeston, MO 63801 | 2007-04-11 |
| 1629195607 | Melissa A Stewart | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 106 Dacus, Sikeston, MO 63801 | 2007-03-23 |
| Find all providers in zip 63801 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801435821 | Helen Morrill | Nurse Practitioner | 760 Plantation Blvd, Sikeston, MO 63801-5736 | 2019-12-23 |
| 1457998809 | Stacy Latham | Nurse Practitioner | 1008 N Main St, Sikeston, MO 63801-5044 | 2019-12-04 |
| 1548729106 | Amber Dawn Towe | Nurse Practitioner | 1012 N Main St, Sikeston, MO 63801 | 2019-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1376152546 | Chijioke Francisca Mbah | Nurse Practitioner | 900 Sw 33rd St, Lees Summit, MO 64082-4191 | 2020-07-23 |
| 1740807825 | Aldijana Sacic | Nurse Practitioner | 8525 Glenwood Dr, Saint Louis, MO 63126-1849 | 2020-07-06 |
| 1639796766 | Courtney Paige Schult | Nurse Practitioner | 431 Stonewater Dr, Pevely, MO 63070-3210 | 2020-07-06 |
| 1912524059 | Farah Lynn Shaddix | Nurse Practitioner | 1103 Warm Winds Dr, O Fallon, MO 63366-6327 | 2020-07-05 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1215551973 | Nicole Lynn Parker | Nurse Practitioner | 1000 Jackson St Apt 1, Saint Charles, MO 63301-2676 | 2020-05-28 |
| 1386273217 | Andrea Morrow Wright | Nurse Practitioner | 8833 N Congress Ave Apt 813, Kansas City, MO 64153-1991 | 2020-04-03 |
| 1700413580 | Solange-belle Boma | Nurse Practitioner | 6326 Ne 44th St, Kansas City, MO 64117-1687 | 2020-03-24 |
| 1063044626 | Beatriz Fortaleza | Nurse Practitioner | 2305 South 65 Highway, Bldg A., Marshall, MO 65340-3702 | 2020-02-11 |
| Find all providers with the same taxonomy | ||||
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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.