Mrs. Shantelle Brokaw
Nurse Practitioner, Psych/Mental Health in Waterbury, Connecticut
1114462561- Practice location
- 128 Cedar Ave, Waterbury, CT 06705-2700
- Phone
- 203-757-9271
- Fax
- —
- Last updated
- April 14, 2020
Shantelle Brokaw is a Nurse Practitioner, Psych/Mental Health based in Waterbury, CT. Shantelle Brokaw practices in Waterbury, CT. The NPI Number for Shantelle Brokaw is 1114462561 and holds a License No. 6831 (CT). The current practice location address for Shantelle Brokaw is 128 Cedar Ave, Waterbury, CT 06705-2700 and can be reached out via phone at 203-757-9271.
Provider Profile Details
- NPI Number
- 1114462561
- Provider Name
- Shantelle Brokaw
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 128 Cedar Ave, Waterbury, CT 06705-2700
- Phone Number
- 203-757-9271
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Sole Proprietor
- No
- Provider Enumeration Date
- December 21, 2016
- Last Update Date
- April 14, 2020
- Certification Date
- April 14, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 128 Cedar Ave
Waterbury, CT 06705-2700 - City
- Waterbury
- State
- Connecticut
- Zip
- 06705-2700
- Phone Number
- 203-757-9271
Provider Business Mailing Address Details
- Address
- 500 Albany Ave
Hartford, CT 06120-2508 - City
- Hartford
- State
- CT
- Zip
- 06120-2508
- Phone Number
- 860-249-9625
- Fax Number
- 860-808-1580
License Information
- License Number
- 6831
- License State
- CT
- Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mrs. Shantelle Brokaw?
The NPI number of Mrs. Shantelle Brokaw is 1114462561. It was assigned on December 21, 2016 and is currently active in the NPPES registry.
What is the specialty of Mrs. Shantelle Brokaw?
Mrs. Shantelle Brokaw is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X), licensed in CT under license number 6831.
Where does Mrs. Shantelle Brokaw practice?
The practice location is 128 Cedar Ave, Waterbury, CT 06705-2700. The office can be reached at 203-757-9271 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1114462561 directly on the NPPES registry website.