KELLY BROOKS (NPI# 1508806530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508806530 |
| Entity Type | Individual |
| Full Name | KELLY BROOKS |
| Other Name | KELLY A JENSEN |
| Credential | CRNA |
| Practice Address |
3564 Willow Beach St Sw Prior Lake MN 55372 |
| Mailing Address |
3564 Willow Beach St Sw Prior Lake MN 55372-2355 |
| Practice Telephone | 9524478207 |
| Mailing Telephone | 9524478207 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2011-02-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | R1036824 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114360484 | Kelly A Brooks | Nutritionist | 2530 Whirlwind St, Corpus Christi, TX 78414-5010 | 2013-04-16 |
| 1366689358 | Kelly Lynn Brooks | Physician Assistant | 828 Ventura St Ste 100, Fillmore, CA 93015 | 2009-01-13 |
| 1083816300 | Kelly Annette Brooks | Counselor | 1224 Pennsylvania St Ne, Albuquerque, NM 87110-7410 | 2007-05-31 |
| 1215073960 | Kelly Dugger Brooks | Social Worker | 4480 Corbin Ct, Tallahassee, FL 32309-2286 | 2007-01-29 |
| 1235750167 | Kelly Brooks | Dietitian, Registered | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2020-05-01 |
| 1407327059 | Kelly Michelle Brooks | Social Worker | 317 N 2nd St, Temple, TX 76501-3216 | 2018-12-07 |
| 1013496850 | Kelly Brooks | Speech-Language Pathologist | 12110 Clayton Rd, Saint Louis, MO 63131-2516 | 2018-08-13 |
| 1336668540 | Kelly Brooks | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2017-09-19 |
| 1881056414 | Kelly Meghan Brooks | Family Medicine | 28 Centre Dr, Milton, VT 05468-3104 | 2016-03-23 |
| 1750717138 | Kelly Robinson Brooks | Registered Nurse | 2141 K St Nw, Suite 3, Washington, DC 20037-1810 | 2013-09-18 |
| Street Address |
3564 WILLOW BEACH ST SW |
| City | PRIOR LAKE |
| State | MN |
| Zip Code | 55372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043830995 | Abby Lynn Quinnell | Physician Assistant | 19455 Towering Oaks Trl, Prior Lake, MN 55372 | 2020-04-21 |
| 1659914547 | Touching Lives Community, Inc. | Assisted Living Facility | 5554 Woodside Road, Se, Prior Lake, MN 55372 | 2019-10-23 |
| 1366961542 | Doreen Lubi Isubikalu | Family Medicine | 2330 Sioux Trail Nw, Prior Lake, MN 55372 | 2017-09-19 |
| 1760909519 | Terese Marie Sovis | Massage Therapist | 15140 Green Oaks Trail, Prior Lake, MN 55372 | 2017-08-23 |
| 1689805301 | Laura Grace Patton | Physician Assistant | 4151 Willowwood Street Se, Prior Lake, MN 55372 | 2009-07-29 |
| 1952582702 | Lilah Suzan Ekim Dds, Ms. Pllc | Dentist | 16190 Erie Ave Se, Prior Lake, MN 55372 | 2007-11-21 |
| 1679618326 | Basile Orthodontics Pa | Dentist | 5116 Gateway Street Se #103, Suite #103, Prior Lake, MN 55372 | 2007-02-20 |
| 1700890134 | Shakopee Mdewakanton Emergency Services | Ambulance | 2525 Flandreau Trail, Prior Lake, MN 55372 | 2006-07-28 |
| 1548299167 | Darlene Merchant | Psychologist | 15815 Franklin Trail S.e., Suite 308 Darlene Merchant, M.a., L.p., Prior Lake, MN 55372 | 2006-07-03 |
| 1235137076 | Barbara Clare | Marriage & Family Therapist | 16180 Hastings Ave Se Ste 205, Prior Lake, MN 55372 | 2005-07-13 |
| Find all providers in zip 55372 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164854188 | Nicole Theisen | Nurse Anesthetist, Certified Registered | 3199 Timberwolf Cir Nw, Prior Lake, MN 55372-3271 | 2013-08-01 |
| 1164400388 | Jed W Adams | Nurse Anesthetist, Certified Registered | 1415 Saint Francis Ave, Anesthesiology, Prior Lake, MN 55379-3374 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285241364 | Jl Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 13359 Isle Dr Ste 1, Baxter, MN 56425-2223 | 2020-09-23 |
| 1932715679 | Kara Biscobing | Nurse Anesthetist, Certified Registered | M Health Fairview Ummc East Bank 3-307, 500 Harvard Street, Minneapolis, MN 55455 | 2020-09-18 |
| 1952916165 | Benjamin Thomas Garbow | Nurse Anesthetist, Certified Registered | 14700 28th Avenue North, Plymouth, MN 55447 | 2020-09-14 |
| 1699306100 | Westpacific Westpac Anesthesia-anesthesia Consultants of Minnesot | Nurse Anesthetist, Certified Registered | 9825 Hospital Dr Ste 203, Maple Grove, MN 55369-4772 | 2020-02-03 |
| 1689211443 | Siripa Min | Nurse Anesthetist, Certified Registered | 640 Jackson Street Mail Stop 11503, St. Paul, MN 55101 | 2019-11-28 |
| 1952946501 | Wyn Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 991 Sibley Memorial Hwy Ste 202, Saint Paul, MN 55118-5116 | 2019-11-07 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1154894202 | Amy Elizabeth Engstrom | Nurse Anesthetist, Certified Registered | 1411 Premier Dr, Mankato, MN 56001-6076 | 2019-01-10 |
| 1215410311 | Hali Jean Haukos | Nurse Anesthetist, Certified Registered | 640 Jackson St - Mail Stop 13901c, Saint Paul, MN 55101-2502 | 2018-09-13 |
| 1154814580 | Ams Minn Pllc | Nurse Anesthetist, Certified Registered | 13601 80th Cir N Ste 100, Maple Grove, MN 55369-8906 | 2018-06-11 |
| Find all providers with the same taxonomy | ||||
| City | PRIOR LAKE |
| Zip Code | 55372 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.