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Individual

MISS NICHOLE V. BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1300 JEFFERSON PARK AVE, CHARLOTTESVILLE, VA 22903-3363
(434) 924-5078
(434) 924-8118
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-08005
NC
363A00000X
Physician Assistant
Primary
0110008971
VA
363A00000X
Physician Assistant
021192
NY

Other

Enumeration date
08/20/2017
Last updated
08/08/2023
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