Provider Demographics
NPI:1588251383
Name:MARTIN, BROOKE (APRN, NP-C)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7708 WATERLILLY LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-7558
Mailing Address - Country:US
Mailing Address - Phone:281-221-5567
Mailing Address - Fax:
Practice Address - Street 1:780 CLEAR LAKE CITY BLVD STE D
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-5500
Practice Address - Country:US
Practice Address - Phone:346-358-7552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018775363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily