BROOKE INDUSTRIES, INC. (NPI# 1689822066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689822066 |
| Entity Type | Organization |
| Organization Name | BROOKE INDUSTRIES, INC. |
| Practice Address |
1257 Industrial Pkwy Fond Du Lac WI 54937-2203 |
| Practice Telephone | 9209243020 |
| Practice Fax Number | 9209243039 |
| Mailing Telephone | 9209243020 |
| Mailing Fax Number | 9209243039 |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2008-08-28 |
| Authorized Official Name | DAVID A. THORNBURG (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9209243020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| Y | 251V00000X | Voluntary or Charitable | 1164-800 | WI | Agencies |
| Street Address |
1257 INDUSTRIAL PKWY |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54937-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710523774 | Lisa Diane Brown | Social Worker | W3950 Wi-23 Trunk, Fond Du Lac, WI 54937 | 2019-11-25 |
| 1538700083 | Kristine Karpen | Technician | 1812 Thurke Ave, North Fond Du Lac, WI 54937 | 2019-10-07 |
| 1962719245 | James Hugh Rupple | Ophthalmology | W4410 Mary Hill Park, Fond Du Lac, WI 54937 | 2010-09-08 |
| 1467591131 | Rosonna Sue Comers | Social Worker | N6687 Wrightway Dr, Ste D, Fond Du Lac, WI 54937 | 2007-02-06 |
| 1487731741 | Daniel James Kierstead | Optometrist | 377 N Rollings Meadows Dr, Fond Du Lac, WI 54937 | 2006-11-01 |
| 1528519758 | Betty Xiong | Physician Assistant | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2016-10-24 |
| 1598112963 | Jennifer M Halbach | Nurse Practitioner | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2016-05-16 |
| 1548667231 | Tanya Watry | Physician Assistant | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2014-11-25 |
| 1578813606 | Joline Brotzman | Nurse Practitioner | 700 Park Ridge Ln, North Fond Du Lac, WI 54937 | 2012-09-17 |
| 1306085998 | Forefront Dermatology, S.c. | Dermatology | 111 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2009-02-05 |
| Find all providers in zip 54937 | ||||
| Taxonomy Code | 251V00000X |
| Grouping | Agencies |
| Classification | Voluntary or Charitable |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54937 |
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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.