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General NPI Number Information
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NPI Number | 1801426895
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Entity Type | Individual
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Provider Name | TIFFANY MICHELLE BROOKS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/19/2020
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Last Update Date | 01/19/2020
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Provider Practice Location Address
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Address Line | 422 E NELSON ST
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City | LEXINGTON
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State | VA
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Zip | 24450-2729
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Country | US
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Telephone | 540-464-1180
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Fax |
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Provider Business Mailing Address
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Address Line | 233 MOUNTAIN BROOK DR
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City | ROANOKE
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State | VA
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Zip | 24012-6574
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Country | US
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Telephone | 276-245-6415
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 0202212148
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License Number State | VA
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