Provider Demographics
NPI:1821971854
Name:DAWE, BROOKE NICHOLE
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:NICHOLE
Last Name:DAWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:N
Other - Last Name:LEIBEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3322 STRAHAN PKWY
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-9162
Mailing Address - Country:US
Mailing Address - Phone:307-672-2044
Mailing Address - Fax:307-426-4740
Practice Address - Street 1:3322 STRAHAN PKWY
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-9162
Practice Address - Country:US
Practice Address - Phone:307-672-2044
Practice Address - Fax:307-426-4740
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker