Denise Polen Brooks, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71001986A Issued in IN

Practice address

420 W Jefferson Ave
Clarksville, IN 47129-1820

Phone

(812) 282-3410

Fax

(812) 282-6178

NPI assigned

Mar 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689643991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W JEFFERSON AVE",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471291820",
            "telephone_number": "812-282-3410",
            "fax_number": "812-282-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W JEFFERSON AVE",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471291820",
            "telephone_number": "812-282-3410",
            "fax_number": "812-282-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "DENISE",
        "middle_name": "POLEN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71001986A",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "4543P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP",
            "identifier": "71001986A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP",
            "identifier": "4543P",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth Jeannette Breitmayer, MED, CSW
• Mallory Brewer
• Julie Marie Brewster
• Janice Lynn Brightwell, PT
• Shawna Brinley
• Hunter Brooks
• Casey Brown, MS, CCC-SLP
• Elena Grace Brown
• Elijah Brown, RBT
• Jennifer R Brown, DDS

• Adult Health Nurse Practitioner in Clarksville, IN
• Providers in Clarksville, IN by specialty
• Adult Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.