Provider Demographics
NPI:1164289070
Name:BROOKS, LAURA B (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:B
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2954
Mailing Address - Country:US
Mailing Address - Phone:845-800-4125
Mailing Address - Fax:
Practice Address - Street 1:500 W MONROE ST STE 1300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-3704
Practice Address - Country:US
Practice Address - Phone:877-751-5783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15009900363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner