Individual
MRS. AMANDA C BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
12255 FAIR LAKES PARKWAY, FAIRFAX, VA 22033-3952
(703) 934-5700
(703) 934-5778
Mailing address
2101 EAST JEFFERSON STREET, PPQA MEDICARE COMPLIANCE UNIT 6 W ATTN THERESA BROOKS, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024124924
VA
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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