Provider Demographics
NPI:1265814693
Name:BROOKS, JAMES (RN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BROOKS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 DUTCH VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WASHBURN
Mailing Address - State:TN
Mailing Address - Zip Code:37888-4607
Mailing Address - Country:US
Mailing Address - Phone:865-978-0366
Mailing Address - Fax:
Practice Address - Street 1:1065 DUTCH VALLEY RD
Practice Address - Street 2:
Practice Address - City:WASHBURN
Practice Address - State:TN
Practice Address - Zip Code:37888-4607
Practice Address - Country:US
Practice Address - Phone:865-978-0366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000198277163W00000X
FLRN9401944163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse