Jean Brockenbrough, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN00038983 Issued in WA

Practice address

16411 NE 24TH St
Bellevue, WA 98008-2427

Phone

(425) 456-5705

Fax

(425) 456-5702

NPI assigned

Dec 14, 2012

Last updated

Dec 14, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1790021095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 HUNTS POINT RD",
            "city": "HUNTS POINT",
            "state": "WA",
            "postal_code": "980041114",
            "telephone_number": "425-454-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16411 NE 24TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980082427",
            "telephone_number": "425-456-5705",
            "fax_number": "425-456-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKENBROUGH",
        "first_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-14",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00038983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; 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.