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NPI Code Detail

MEDICARE: NANCY L BROOKS PA

MEDICARE: NANCY L BROOKS PA
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
1363A00000XPhysician Assistant750SC

General Provider Information

NPI Number : 1437187168
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY L BROOKS PA
Provider Business Mailing Address
First Line : 1818 HENDERSON ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-2619
Country : US
Telephone Number : 803-758-2600
Fax Number : 803-253-8896
Provider Business Practice Location Address
First Line : 743 FOLLY RD
Second Line :
City : CHARLESTON
State : SC
Zip : 29412-3432
Country : US
Telephone Number : 843-762-2360
Fax Number : 843-762-2340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2006
Last Update Date : 12/14/2010

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Directions to “ NANCY L BROOKS PA” Practice Location

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