Provider Demographics
NPI:1952136236
Name:BROOKS, CHRISTY CAMILLE (RD)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:CAMILLE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 PETER LN
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:AL
Mailing Address - Zip Code:35760-9100
Mailing Address - Country:US
Mailing Address - Phone:256-783-6426
Mailing Address - Fax:
Practice Address - Street 1:110 PETER LN
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:AL
Practice Address - Zip Code:35760-9100
Practice Address - Country:US
Practice Address - Phone:256-783-6426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5333133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered