Provider Demographics
NPI:1831753763
Name:SCURRY, BROOKS EDWARDS (FNP-BC)
Entity type:Individual
Prefix:
First Name:BROOKS
Middle Name:EDWARDS
Last Name:SCURRY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:BROOKS
Other - Middle Name:LEE
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:193 W SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4448
Mailing Address - Country:US
Mailing Address - Phone:803-767-3052
Mailing Address - Fax:
Practice Address - Street 1:2809 COLTSGATE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-5583
Practice Address - Country:US
Practice Address - Phone:704-733-9202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily