Provider Demographics
NPI:1063469559
Name:BROOKS, VICKI D (NP)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:D
Last Name:BROOKS
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:214 SW 26TH AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-8249
Mailing Address - Country:US
Mailing Address - Phone:940-325-9485
Mailing Address - Fax:940-325-4325
Practice Address - Street 1:214 SW 26TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-8249
Practice Address - Country:US
Practice Address - Phone:940-325-9485
Practice Address - Fax:940-325-4325
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2016-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX604324363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care