MEDICARE: JENNIFER YOUNG BROOKS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	1178432	TN

General Provider Information

NPI Number	:	1164790317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER YOUNG BROOKS PHARMD

Provider Business Mailing Address
First Line	:	5006 N BROADWAY ST
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-2340
Country	:	US
Telephone Number	:	865-688-1812
Fax Number	:

Provider Business Practice Location Address
First Line	:	5006 NORTH BROADWAY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918
Country	:	US
Telephone Number	:	865-688-1812
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2011
Last Update Date	:	12/02/2011

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