Individual
AMANDA JANE BROKKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2701 E STAN SCHLUETER LOOP STE 100, KILLEEN, TX 76542-3810
(855) 876-7246
(855) 277-5070
Mailing address
PO BOX 208379, DALLAS, TX 75320-8382
(512) 485-7208
(844) 364-8678
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
88406
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP121982
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2J7040
TEXAS MEDICARE PTAN
TX
01
—
AP121982
TEXAS CRNA LICENSE
TX
Enumeration date
05/28/2012
Last updated
03/10/2023
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