Individual
MR. BROOK H. ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
629 S PLUMMER AVE, CHANUTE, KS 66720
(620) 431-4000
(620) 431-7556
Mailing address
1008 OSA MARTIN BLVD, CHANUTE, KS 66720-1830
(316) 833-1165
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
111346
OK
367500000X
Certified Registered Nurse Anesthetist
557008
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
02/23/2011
Last updated
08/19/2018
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