Individual
MICHELLE L BROKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1602 N AYLWARD AVE, ELLSWORTH, KS 67439-2541
(785) 472-3111
(785) 472-5731
Mailing address
1602 N AYLWARD AVE, PO BOX 103, ELLSWORTH, KS 67439-2541
(785) 472-3111
(785) 472-5731
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
T01546
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200548240C
—
KS
01
—
T01546
STATE LICENSE
KS
Enumeration date
09/10/2007
Last updated
12/17/2009
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