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NPI Code Detail

MEDICARE: MRS. JODY BROOKS ROBERTS FNP-C

MEDICARE: MRS. JODY BROOKS ROBERTS FNP-C
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
1163W00000XRegistered Nurse687351TX
2363LF0000XFamily Nurse Practitioner687351TX

General Provider Information

NPI Number : 1316135619
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JODY BROOKS ROBERTS FNP-C
Provider Business Mailing Address
First Line : PO BOX 689022
Second Line :
City : FRANKLIN
State : TN
Zip : 37068-9022
Country : US
Telephone Number : 866-398-7107
Fax Number : 615-465-2879
Provider Business Practice Location Address
First Line : 2301 S GREGG ST
Second Line :
City : BIG SPRING
State : TX
Zip : 79720-5531
Country : US
Telephone Number : 432-267-5531
Fax Number : 432-267-2025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2007
Last Update Date : 11/18/2013

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