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General NPI Number Information
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NPI Number | 1730985953
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Entity Type | Individual
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Provider Name | JUSTINE DIANE BROOKINS NP
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Gender | Female
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 1837 UPPER WETUMPKA RD
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City | MONTGOMERY
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State | AL
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Zip | 36107-1304
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Country | US
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Telephone | 334-264-8416
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Fax |
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Provider Business Mailing Address
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Address Line | 1837 UPPER WETUMPKA RD
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City | MONTGOMERY
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State | AL
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Zip | 36107-1333
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Country | US
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Telephone | 334-450-8012
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1-150193
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License Number State | AL
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