Provider Demographics
NPI:1023072121
Name:BROOKS, CHRISTOPHER (CRNFA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:BROOKS
Suffix:
Gender:M
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2485 E CLARK DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-3133
Mailing Address - Country:US
Mailing Address - Phone:623-204-9191
Mailing Address - Fax:
Practice Address - Street 1:2485 E CLARK DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-3133
Practice Address - Country:US
Practice Address - Phone:623-204-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN078229163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z5694OtherHEALTHNET OF AZ
AZAZ0148910OtherBCBS AZ
AZ557465Medicaid