Healthcare Provider Details

I. General information

NPI: 1508239344
Provider Name (Legal Business Name): REBECCA LYNN BROOKS MSN, RN, PCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2015
Last Update Date: 10/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 MEDICAL DISTRICT DR
DALLAS TX
75235-7701
US

IV. Provider business mailing address

1935 MEDICAL DISTRICT DR
DALLAS TX
75235-7701
US

V. Phone/Fax

Practice location:
  • Phone: 214-456-0371
  • Fax:
Mailing address:
  • Phone: 214-456-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License NumberAP129000
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: