Provider Demographics
NPI:1043000839
Name:BROOKS, JULIE RAE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:RAE
Last Name:BROOKS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:RAE
Other - Last Name:JUSTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:LEROY
Mailing Address - State:MI
Mailing Address - Zip Code:49655-5115
Mailing Address - Country:US
Mailing Address - Phone:231-388-4339
Mailing Address - Fax:
Practice Address - Street 1:120 PALUSTER ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-2532
Practice Address - Country:US
Practice Address - Phone:231-775-7341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program