Brooke Elizabeth Prine, IDMT
Individual provider Active NPI Independent Duty Medical Technicians · McConnell Afb, KS
NPI 1740613397 · NPPES record last updated Aug 19, 2013
Key facts
- NPI
- 1740613397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Medical Technicians 1710I1003X
- Practice address
- 57950 Leavenworth St
McConnell Afb, KS 67221-3506 - Phone
- (316) 759-5116
- NPI assigned
- Aug 19, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Yes |
Addresses
Primary practice location
57950 Leavenworth St
McConnell Afb, KS 67221-3506
Mailing address
407 E Stone Path St
Derby, KS 67037-9395
Phone (937) 430-4451
Other providers in McConnell Afb, KS
- Richard L Nault
- Alisa A Norlin
- Harmony Osborn
- Thoa Ngoc Pham
- Allen Lee Plangklang
- Timothy Rafferty
- Jeremiah Gregory Raymo
- Levi Josiah Rickards
- Richard Jimenez Rubi
- Jessica Rynders
All providers in McConnell Afb, KS · Independent Duty Medical Technicians in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2013. 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.