Provider Demographics
NPI:1447065032
Name:EILTS, BROOKE J
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:J
Last Name:EILTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3323 N HOMESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-9596
Mailing Address - Country:US
Mailing Address - Phone:308-390-2019
Mailing Address - Fax:
Practice Address - Street 1:3323 N HOMESTEAD DR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-9596
Practice Address - Country:US
Practice Address - Phone:308-390-2019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion