Provider Demographics
NPI:1891244661
Name:BROOKS, ALEXANDRIA COPELAND (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:COPELAND
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4079
Mailing Address - Country:US
Mailing Address - Phone:912-348-2100
Mailing Address - Fax:
Practice Address - Street 1:135 CANAL ST
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4079
Practice Address - Country:US
Practice Address - Phone:912-348-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN218653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily