Individual
BROOKE ELLEN DREISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 593-8441
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP120298
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315303302
—
TX
05
—
315303303
—
TX
05
—
315303304
—
TX
05
—
315303305
—
TX
01
—
75-0818167-015
TRICARE
TX
01
—
75-0818167-022
TRICARE
TX
01
—
75-0818167-044
TRICARE
TX
01
—
75-0818167-048
TRICARE
TX
01
—
75-1976930-005
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-028
TRICARE
TX
01
—
8505NF
BCBS
TX
01
—
8506NF
BCBS
TX
01
—
8507NF
BCBS
TX
01
—
8508NF
BCBS
TX
Enumeration date
06/20/2011
Last updated
04/01/2016
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