Provider Demographics
NPI:1659721918
Name:BROOKS, JAMES (NP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BROOKS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 FIELDSTOWN RD STE 124
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-2418
Mailing Address - Country:US
Mailing Address - Phone:205-285-8252
Mailing Address - Fax:205-285-8262
Practice Address - Street 1:210 FIELDSTOWN RD STE 124
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2418
Practice Address - Country:US
Practice Address - Phone:205-285-8252
Practice Address - Fax:205-285-8262
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-131729363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner