Provider Demographics
NPI:1255214524
Name:BROOKS, SHAMBRICA
Entity type:Individual
Prefix:
First Name:SHAMBRICA
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 728
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:GA
Mailing Address - Zip Code:30646-0728
Mailing Address - Country:US
Mailing Address - Phone:762-338-8402
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 728
Practice Address - Street 2:
Practice Address - City:HULL
Practice Address - State:GA
Practice Address - Zip Code:30646-0728
Practice Address - Country:US
Practice Address - Phone:762-338-8402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374700000X
GA246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No374700000XNursing Service Related ProvidersTechnician