MEDICARE: MRS. THANH TRUC NU BROOKS 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
1	363LF0000X	Family Nurse Practitioner	201979	NC

General Provider Information

NPI Number	:	1780662056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. THANH TRUC NU BROOKS FNP-C

Provider Business Mailing Address
First Line	:	303 GREEN ST E
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-4105
Country	:	US
Telephone Number	:	252-293-0013
Fax Number	:	252-243-2576

Provider Business Practice Location Address
First Line	:	8250 SOUTH NC 58
Second Line	:
City	:	ELM CITY
State	:	NC
Zip	:	27822-8947
Country	:	US
Telephone Number	:	252-443-7744
Fax Number	:	252-443-7611

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

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	10/26/2023

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