Provider Demographics
NPI:1174629364
Name:BROOKS, VICTORIA C (APNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:C
Last Name:BROOKS
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:117 N PELHAM ST
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-3151
Mailing Address - Country:US
Mailing Address - Phone:715-361-4700
Mailing Address - Fax:715-361-4343
Practice Address - Street 1:2251 N SHORE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-8360
Practice Address - Country:US
Practice Address - Phone:715-361-4700
Practice Address - Fax:715-361-4343
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI2927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIQ72863Medicare UPIN