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Individual

MISS JENNIFER LYNNE BROOKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
1801 N 6TH ST STE 600, TERRE HAUTE, IN 47804-4097
(812) 235-4867
(812) 232-8059
Mailing address
1801 N 6TH ST STE 600, TERRE HAUTE, IN 47804-4097
(812) 235-4867
(812) 232-8059

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085003316
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
153063
HEALTH ALLIANCE
01
940939
HEALTHLINK
Enumeration date
09/24/2008
Last updated
05/19/2014
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