Healthcare Provider Details

I. General information

NPI: 1376325381
Provider Name (Legal Business Name): ANN BROOKS ARNOLD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANN BROOKS JOHNSON

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 10/16/2023
Certification Date: 10/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 MONROE ST STE E512
HOBOKEN NJ
07030-6360
US

IV. Provider business mailing address

860 ARMAND CT NE
ATLANTA GA
30324-4201
US

V. Phone/Fax

Practice location:
  • Phone: 917-647-1665
  • Fax:
Mailing address:
  • Phone: 205-516-5812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: