Healthcare Provider Details

I. General information

NPI: 1487588331
Provider Name (Legal Business Name): TINA BROOKS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL CENTER BLVD
STAFFORD VA
22554-6200
US

IV. Provider business mailing address

5813 DEEP CREEK DR
FREDERICKSBURG VA
22407-9221
US

V. Phone/Fax

Practice location:
  • Phone: 540-741-9299
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number0001242665
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number0001242665
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number0001242665
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: