Provider Demographics
NPI:1528371028
Name:BROOKS, TANYA LEE (RN, MSN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:LEE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:RN, MSN, FNP-BC
Other - Prefix:
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Mailing Address - Street 1:2700 ROBERT T. LONGWAY
Mailing Address - Street 2:SUITE H
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503
Mailing Address - Country:US
Mailing Address - Phone:810-235-1746
Mailing Address - Fax:810-262-2333
Practice Address - Street 1:2700 ROBERT T LONGWAY BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2190
Practice Address - Country:US
Practice Address - Phone:810-235-1746
Practice Address - Fax:810-262-2333
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704189065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily