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General NPI Number Information
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NPI Number | 1306100672
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Entity Type | Individual
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Provider Name | HEATHER L BROOKS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/01/2012
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Last Update Date | 01/06/2013
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Provider Practice Location Address
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Address Line | 1570 LINDBERG DR # 10-12
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City | SLIDELL
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State | LA
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Zip | 70458-8083
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Country | US
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Telephone | 985-643-5242
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Fax |
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Provider Business Mailing Address
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Address Line | 115 PINE CIR
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City | SLIDELL
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State | LA
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Zip | 70458-1138
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Country | US
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Telephone | 504-913-5454
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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 | AP06867
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R892477
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License Number State | MS
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