Individual
JANA MICHELLE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
7810 PROVIDENCE ROAD, SUITE 102, CHARLOTTE, NC 28226-2987
(704) 543-6636
(704) 541-9476
Mailing address
PO BOX 601448, CHARLOTTE, NC 28260-1448
(704) 543-6636
(704) 541-9476
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
005001010
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7005796
—
NC
Enumeration date
10/31/2005
Last updated
12/04/2012
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