Provider Demographics
NPI:1548577570
Name:JAMES, BROOKE MAYO (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:MAYO
Last Name:JAMES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18037 N 51ST WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-7620
Mailing Address - Country:US
Mailing Address - Phone:318-426-8745
Mailing Address - Fax:
Practice Address - Street 1:8520 E SHEA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6677
Practice Address - Country:US
Practice Address - Phone:480-588-6924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN121135-AP06272363LF0000X
AZAP4966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LARN121135-AP06272OtherAPRN LICENSE NUMBER
AZAP4966OtherAPRN LICENSE