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Individual

MRS. KELSEY RENEE BROKAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP-BC

Contact information

Practice address
140 FOX RD, VAN WERT, OH 45891-2475
(419) 238-7727
(419) 238-7768
Mailing address
21051 ROAD T, FORT JENNINGS, OH 45844-9307

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP13989
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0080308
OH
Enumeration date
11/07/2012
Last updated
04/18/2024
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