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General NPI Number Information
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NPI Number | 1255299350
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Entity Type | Individual
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Provider Name | TYLER BROOKS
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Gender | Male
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 8609 WESTWOOD CENTER DR STE 110
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City | TYSONS CORNER
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State | VA
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Zip | 22182-7525
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Country | US
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Telephone | 703-722-4828
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 WILLOW BRANCH CT
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City | VIENNA
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State | VA
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Zip | 22181-2972
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024194633
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License Number State | VA
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