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General NPI Number Information
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NPI Number | 1063783504
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Entity Type | Individual
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Provider Name | SHARON AGNES BROOKS CRNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/14/2012
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Last Update Date | 01/14/2012
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Provider Practice Location Address
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Address Line | 19201 MONTGOMERY VILLAGE AVE
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City | GAITHERSBURG
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State | MD
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Zip | 20886-5027
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Country | US
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Telephone | 301-670-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 14809 KELLEY FARM DR
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City | DARNESTOWN
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State | MD
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Zip | 20874-3619
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Country | US
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Telephone | 240-631-8970
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R098232
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License Number State | MD
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