Individual
NICHOLE MARIE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4107 W MERCURY BLVD, RIVERSIDE PACE, HAMPTON, VA 23666-3729
(757) 251-7977
Mailing address
856 J CLYDE MORRIS BLVD STE A, RIVERSIDE MEDICAL GROUP, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
0024172837
VA
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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