Individual
BROOKE NICOLE TIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CFNP
Contact information
Practice address
810 E SUNFLOWER RD STE 100A, CLEVELAND, MS 38732-2828
(662) 843-3606
Mailing address
810 E SUNFLOWER RD STE 100A, CLEVELAND, MS 38732-2828
(662) 843-3606
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R868828
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05983815
—
MS
Enumeration date
07/24/2006
Last updated
06/28/2021
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