Healthcare Provider Details

I. General information

NPI: 1538566096
Provider Name (Legal Business Name): TERI BROOKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2014
Last Update Date: 11/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3285 S VAL VISTA DR
GILBERT AZ
85297-7000
US

IV. Provider business mailing address

3285 S VAL VISTA DR
GILBERT AZ
85297-7000
US

V. Phone/Fax

Practice location:
  • Phone: 480-397-2820
  • Fax: 480-825-7290
Mailing address:
  • Phone: 480-397-2820
  • Fax: 480-825-7290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: