Provider Demographics
NPI:1497881510
Name:BROOKS-WARREN, JUANITA ANNETTE (M D)
Entity Type:Individual
Prefix:DR
First Name:JUANITA
Middle Name:ANNETTE
Last Name:BROOKS-WARREN
Suffix:
Gender:F
Credentials:M D
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Mailing Address - Street 1:1655 ARROWHEAD TRL NE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-4115
Mailing Address - Country:US
Mailing Address - Phone:404-325-8780
Mailing Address - Fax:404-321-5670
Practice Address - Street 1:1655 ARROWHEAD TRL NE
Practice Address - Street 2:SUITE 11
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-4115
Practice Address - Country:US
Practice Address - Phone:404-325-8780
Practice Address - Fax:404-321-5670
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0249072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD39492Medicare UPIN