Provider Demographics
NPI:1508904517
Name:BROOKS, RHONDA (RNC, WHNP)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:RNC, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-2251
Mailing Address - Country:US
Mailing Address - Phone:706-647-9627
Mailing Address - Fax:706-647-9651
Practice Address - Street 1:214 CHEROKEE RD
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-3402
Practice Address - Country:US
Practice Address - Phone:706-647-9627
Practice Address - Fax:706-647-9651
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR050475363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00740209AMedicaid
GA50BBBVPMedicare ID - Type Unspecified