Individual
TIERNARY BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2626 FAIRFIELD AVE, FORT WAYNE, IN 46807-1215
(260) 235-5900
Mailing address
7606 MELODY CIR W, FORT WAYNE, IN 46816-4875
(260) 804-7617
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71012806A
IN
Other
Enumeration date
07/18/2022
Last updated
01/26/2023
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