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General NPI Number Information
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NPI Number | 1104892876
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Entity Type | Individual
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Provider Name | BONNIE JEAN BROOKS M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 9500 RICHMOND HIGHWAY SENTARA FAMILY MEDICINE PHYSICIANS
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City | LORTON
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State | VA
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Zip | 22079-2124
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Country | US
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Telephone | 571-800-8915
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Fax | 833-954-5512
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Provider Business Mailing Address
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Address Line | 11803 JEFFERSON AVE STE 140
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2565
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Country | US
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Telephone | 757-594-1803
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Fax | 757-594-1828
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101245687
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License Number State | VA
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