MRS. KELSEY RENEE BROKAMP (NPI# 1790039196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790039196 |
| Entity Type | Individual |
| Full Name | MRS. KELSEY RENEE BROKAMP |
| Credential | ANP-BC |
| Practice Address |
140 Fox Rd Van Wert OH 45891-2475 |
| Mailing Address |
21051 Road T Fort Jennings OH 45844-9307 |
| Practice Telephone | (419) 238-7727 |
| Practice Fax Number | 4192387768 |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2019-12-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
NP13989 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0080308 | 05 |
| Street Address |
140 FOX RD |
| City | VAN WERT |
| State | OH |
| Zip Code | 45891-2475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225032964 | Matthew W. Miller | Family Medicine | 140 Fox Rd, Suite 202, Van Wert, OH 45891-2475 | 2005-06-10 |
| 1467994541 | Van Wert Medical Services, Ltd. | Podiatrist | 140 Fox Rd, Ste 209, Van Wert, OH 45891-2475 | 2016-11-07 |
| 1437521317 | Dental Center of Northwest Ohio | Clinic/Center | 140 Fox Rd, Suite 207, Van Wert, OH 45891-2475 | 2015-10-30 |
| 1215313846 | Shelley Kreeger | Specialist/Technologist | 140 Fox Rd, Suite 101, Van Wert, OH 45891-2475 | 2015-08-05 |
| 1396150272 | Allison Harting | Nurse Practitioner | 140 Fox Rd, Ste 201, Van Wert, OH 45891-2475 | 2014-06-30 |
| 1467867325 | Deborah Nicole Howell | Nurse Practitioner | 140 Fox Rd, Suiet 402, Van Wert, OH 45891-2475 | 2014-06-30 |
| 1386082923 | Kelly Jae Straley | Registered Nurse | 140 Fox Rd, Van Wert, OH 45891-2475 | 2013-06-05 |
| 1487097317 | Serenity Solutions, LLC | Psychologist | 140 Fox Rd, Suite 303, Van Wert, OH 45891-2475 | 2013-04-10 |
| 1124369350 | Van Wert Medical Services, Ltd. | General Practice | 140 Fox Rd, Suite 104, Van Wert, OH 45891-2475 | 2013-03-13 |
| 1114287240 | Kathy Marie Carr | Psychologist | 140 Fox Rd, Suite 303, Van Wert, OH 45891-2475 | 2012-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821638172 | Katlynn A Dotson | Social Worker | 160 Fox Road, Van Wert, OH 45891 | 2020-01-14 |
| 1982107975 | Van Wert Medical Services, Ltd. | Clinic/Center | 214 Towne Center Blvd, Van Wert, OH 45891 | 2018-03-15 |
| 1871800698 | Ronetta E Marhoover | Nurse Practitioner | 1052 S Washington Street, Van Wert, OH 45891 | 2010-09-01 |
| 1780918243 | Sherry Ann Eibling | Nurse's Aide | 3683 St Rt 127n, Van Wert, OH 45891 | 2009-09-30 |
| 1053552596 | Betty Jean Miller | Massage Therapist | 7079 Us. Rt. 127 N., Van Wert, OH 45891 | 2009-03-12 |
| 1578700399 | P & R Home Iv Service Inc | Pharmacy | 16937 Defiance Trail, Van Wert, OH 45891 | 2009-01-15 |
| 1619167236 | Scott David Shie | Urology | Van Wert Health Urology, 140 Fox Rd. Ste 105, Van Wert, OH 45891 | 2007-07-30 |
| 1386866283 | John Carl Cook Jr. | Dentist | 723 W Main St, Van Wert, OH 45891 | 2007-05-02 |
| 1396866620 | Orthopaedic Institute of Ohio, Inc. | Orthopaedic Surgery | 1180 Professional Drive, Van Wert, OH 45891 | 2007-04-03 |
| 1659400224 | Hearth & Home Assisted Living | Assisted Living Facility | 1118 Westwood Drive, Van Wert, OH 45891 | 2007-03-02 |
| Find all providers in zip 45891 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394235 | Lisa Ann Popovich | Nurse Practitioner | 3703 Canon Ridge Pl, Columbus, OH 43230-4010 | 2020-10-17 |
| 1598362402 | Kate Suzanne Mccombs | Nurse Practitioner | 6681 Ridge Rd Ste 30, Parma, OH 44129-5705 | 2020-10-04 |
| 1013523745 | Yangyang Hu | Nurse Practitioner | 2042 Golden Oaks Dr, Kent, OH 44240-8198 | 2020-09-17 |
| 1659982494 | Lauren Rainey | Nurse Practitioner | 70 N Hillside Rd, Canfield, OH 44406-1335 | 2020-08-14 |
| 1932710928 | Bobbie Duda | Nurse Practitioner | 6454 Paine Rd, Painesville, OH 44077-9318 | 2020-08-12 |
| 1235756461 | Sara Mauk | Nurse Practitioner | 6780 Mayfield Rd Rm 323, Mayfield Heights, OH 44124-2203 | 2020-07-04 |
| 1629694153 | Laraine Elizabeth Tench | Nurse Practitioner | 9500 Euclid Ave # G110, Cleveland, OH 44195-0001 | 2020-06-20 |
| 1316563109 | Isabelle Noffsinger | Nurse Practitioner | 6443 Far Hills Ave, Washington Township, OH 45459-2725 | 2020-06-17 |
| 1497375604 | Allison Ferguson | Nurse Practitioner | 3641 Shepherd St Nw, North Canton, OH 44720-7949 | 2020-04-17 |
| 1154940708 | Elizabeth Clare Gaydosh | Nurse Practitioner | 4680 Autumn Run Dr, Medina, OH 44256-8821 | 2020-04-14 |
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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.