Individual
BROOKE JENNA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1450 FERN CREEK DR, STATESVILLE, NC 28625-9376
(424) 070-4237
Mailing address
170 MEDICAL PARK RD STE 208, MOORESVILLE, NC 28117-8541
(704) 237-4240
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-13641
NC
Other
Enumeration date
08/21/2023
Last updated
10/28/2024
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