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Individual

BROOKE DENISE BOOHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-C

Contact information

Practice address
611 BELL RD SE, CLEVELAND, TN 37323-9003
(423) 715-0897
Mailing address
611 BELL RD SE, CLEVELAND, TN 37323-9003
(423) 728-4020

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
27712
TN
363LF0000X
Family Nurse Practitioner
F06200392
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14677662
CAQH
Enumeration date
06/24/2020
Last updated
06/24/2020
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