Healthcare Provider Details

I. General information

NPI: 1003391129
Provider Name (Legal Business Name): SARAH KATELYN BROOKS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH KATELYN REAVES PA-C

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 S DAISY ST
MORRISTOWN TN
37813-2362
US

IV. Provider business mailing address

3974 CLAIRE LN
MORRISTOWN TN
37814-7606
US

V. Phone/Fax

Practice location:
  • Phone: 423-616-8315
  • Fax: 423-616-8316
Mailing address:
  • Phone: 423-258-1047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3691
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: