Individual provider Active NPI

Christine Lynn Brouk, RN,BSN,CNOR,RNFA

  • Registered Nurse First Assistant
  • Plano, TX
National Provider Identifier
1952469736
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
676742 Issued in TX
Practice address
4564 Bentley Dr
Plano, TX 75093-7151
Phone
(214) 566-4574
Fax
(469) 241-9096
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 676742 TX Primary

Addresses

Primary practice location

4564 Bentley Dr
Plano, TX 75093-7151

Mailing address

PO Box 867166
Plano, TX 75086-7166
Phone (214) 566-4574

Other identifiers 1

IdentifierTypeStateIssuer
37HTOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
676742TXMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952469736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 867166",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750867166",
            "telephone_number": "214-566-4574",
            "fax_number": "469-241-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4564 BENTLEY DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937151",
            "telephone_number": "214-566-4574",
            "fax_number": "469-241-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUK",
        "first_name": "CHRISTINE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "RN,BSN,CNOR,RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "TX",
            "license": "676742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37HT",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • 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.