Christine A Brokel, FNP

Key facts

NPI

1619045705

Entity type

Individual (NPI type 1)

Primary specialty

Nurse Practitioner 363L00000X

License

2006500111FNP (OR)

Practice address

1200 Mira Mar Ave
Medford, OR 97504-8546

Phone

(541) 857-7133

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Asante Community Services LLC Home Infusion Agency · Medford, OR · NPI 1497821052
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619045705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E MAIN ST",
            "address_2": "SUITE C",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975016041",
            "telephone_number": "541-789-5526",
            "fax_number": "541-789-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MIRA MAR AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048546",
            "telephone_number": "541-857-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKEL",
        "first_name": "CHRISTINE",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "2006500111FNP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Medford, OR · Nurse Practitioner in Oregon