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Individual

MS. ROBERTA J BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2127 E HARMONY RD, SUITE 140, FORT COLLINS, CO 80528-3405
(970) 297-6250
(970) 297-6260
Mailing address
3055 SANFORD CIR, SUITE 150, LOVELAND, CO 80538-4925
(970) 624-4420
(970) 624-4459

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2595
CO
363AM0700X
Medical Physician Assistant
1500312
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100377320D
KS
Enumeration date
03/24/2006
Last updated
03/26/2013
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