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General NPI Number Information
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NPI Number | 1093098287
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Entity Type | Individual
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Provider Name | KRISTY NICOLE BROOKS PHARMACY TECHNICIAN
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Gender | Female
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 30 PERIMETER PARK DRIVE
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City | ATLANTA
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State | GA
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Zip | 30341
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Country | US
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Telephone | 479-201-8216
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Fax | 866-828-7724
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Provider Business Mailing Address
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Address Line | 30 PERIMETER PLACE PK
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City | ATLANTA
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State | GA
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Zip | 30341
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Country | US
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Telephone | 479-201-8216
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Fax | 866-828-7724
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 520107010101313
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License Number State | GA
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