Individual provider Active NPI

Kristie Lynn Brooke, FNP

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1053486720
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2768033 Issued in WI
Practice address
5460 N 64TH St
Milwaukee, WI 53218-3020
Phone
(414) 535-0432
Fax
(414) 535-0373
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2768033 WI Primary

Addresses

Primary practice location

5460 N 64TH St
Milwaukee, WI 53218-3020

Mailing address

5460 N 64TH St
Milwaukee, WI 53218-3020
Phone (414) 535-0432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2768033WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin System Non Payroll Past Accepting new patients
University of Wisconsin System Non Payroll PastSince Sep 5, 2016 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1053486720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 N 64TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532183020",
            "telephone_number": "414-535-0432",
            "fax_number": "414-535-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 N 64TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532183020",
            "telephone_number": "414-535-0432",
            "fax_number": "414-535-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKE",
        "first_name": "KRISTIE",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "2768033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.