Healthcare Provider Details

I. General information

NPI: 1467321307
Provider Name (Legal Business Name): EMMA BROOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 PROVIDENCE DR
ANCHORAGE AK
99508-4615
US

IV. Provider business mailing address

4208 NEEDLE CIR
ANCHORAGE AK
99508-5138
US

V. Phone/Fax

Practice location:
  • Phone: 907-562-2211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number192722
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: