Kellie Lane Brooksher, NP
Individual provider Active NPI Adult Health Nurse Practitioner · Yuma, AZ
NPI 1346929924 · NPPES record last updated Jul 12, 2023
Key facts
- NPI
- 1346929924
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- RNP294682 (AZ)
- Practice address
- 1951 W 25TH St Ste D
Yuma, AZ 85364-6924 - Phone
- (928) 344-6263
- Fax
- (928) 317-0544
- NPI assigned
- Jul 12, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RNP294682 | AZ | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ronald D Brooksher MD PLLC | Current |
Accepting new patients | |
| Gila Valley Medical Group LLC | Past |
Accepting new patients |
Locations
1951 W 25th St
Ste D
Yuma, AZ 85364
Phone (928) 344-6263
Interoperability endpoints
- ronaldbrookshermd.kelliebrooksher@157245.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | RNP294682 | AZ | Yes |
Addresses
Primary practice location
1951 W 25TH St Ste D
Yuma, AZ 85364-6924
Mailing address
1951 W 25TH St Ste D
Yuma, AZ 85364-6924
Phone (928) 344-6263
Other providers in Yuma, AZ
- Julie Denise Brito
- Jennifer J Brittenham
- Sandra Broadhead
- Cynthia Dianne Brodie
- Stacey D Brooks
- Ronald D Brooksher
- Ariane Louise Brown
- Loretta Brown
- Robert C. Brown
- James Browning
All providers in Yuma, AZ · Adult Health Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.