Basic Information
| Provider Information | |||||||||
| NPI: | 1700407012 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | UNDERBRINK | ||||||||
| FirstName: | BROOKE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1611 DAILY DR | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805167232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037752221 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7307 S REVERE PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801123931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033554745 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2020 | ||||||||
| LastUpdateDate: | 04/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WI0500X | 0174919 | CO | Y | Nursing Service Providers | Registered Nurse | Infusion Therapy |
No ID Information.