Individual
JOHANNA M BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14239 WEST BELL ROAD, SUITE 112, SURPRISE, AZ 85374-2469
(623) 876-9983
(623) 876-9984
Mailing address
14239 WEST BELL ROAD, SUITE 112, SURPRISE, AZ 85374-2469
(623) 876-9983
(623) 876-9984
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3785
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3785
ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS
AZ
Enumeration date
05/08/2006
Last updated
10/28/2014
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