Healthcare Provider Details
I. General information
NPI: 1659294890
Provider Name (Legal Business Name): JENNIFER LEE BROOKS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
34225 N 27TH DR STE 140
PHOENIX AZ
85085-6090
US
IV. Provider business mailing address
34225 N 27TH DR STE 140
PHOENIX AZ
85085-6090
US
V. Phone/Fax
- Phone: 602-492-3692
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 343605 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: