Individual
BETHANY BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1875 UNIVERSITY AVE S, FAIRBANKS, AK 99709-4916
(907) 328-0875
Mailing address
872 RIDGE LOOP RD UNIT A, NORTH POLE, AK 99705-5346
(605) 290-5792
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
215639
AK
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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