Provider Demographics
NPI:1134999766
Name:BROOKS, NANCY KATHRYN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:KATHRYN
Last Name:BROOKS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6613 BEAVER TRL
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31820-3734
Mailing Address - Country:US
Mailing Address - Phone:762-822-3262
Mailing Address - Fax:
Practice Address - Street 1:6613 BEAVER TRL
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:GA
Practice Address - Zip Code:31820-3734
Practice Address - Country:US
Practice Address - Phone:762-822-3262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN228230363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily