Provider Demographics
NPI:1952640229
Name:BROOKS, SHERRI LEE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:LEE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 COLLEGE PARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-0600
Mailing Address - Country:US
Mailing Address - Phone:706-965-4060
Mailing Address - Fax:706-965-4080
Practice Address - Street 1:45 COLLEGE PARK DR STE A
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-0600
Practice Address - Country:US
Practice Address - Phone:706-965-4060
Practice Address - Fax:706-965-4080
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN112456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003138648Medicaid
GA102I508974Medicare PIN