Provider Demographics
NPI:1134472194
Name:CROOKS, BRINLY J (PA-C)
Entity Type:Individual
Prefix:
First Name:BRINLY
Middle Name:J
Last Name:CROOKS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1701 E THOMAS RD
Mailing Address - Street 2:#A104
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7646
Mailing Address - Country:US
Mailing Address - Phone:480-845-4445
Mailing Address - Fax:602-277-9360
Practice Address - Street 1:1701 E THOMAS RD
Practice Address - Street 2:#A104
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7646
Practice Address - Country:US
Practice Address - Phone:480-845-4445
Practice Address - Fax:602-277-9360
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2017-04-17
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Provider Licenses
StateLicense IDTaxonomies
AZ6650363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant