Healthcare Provider Details

I. General information

NPI: 1437985314
Provider Name (Legal Business Name): SYDNEY BROOKS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 DICKERSON PIKE STE 370
NASHVILLE TN
37207-2535
US

IV. Provider business mailing address

3443 DICKERSON PIKE STE 370
NASHVILLE TN
37207-2535
US

V. Phone/Fax

Practice location:
  • Phone: 615-769-2799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6204
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: