Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN11000013 | FL |
NPI | 1003216334 |
---|---|
Provider Name | Natasha Brooks |
First Address | Ocala, FL 34476-8747 |
Second Address | Wildwood, FL 34785-8694 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2014 |
Last Update Date | 29/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
APRN11000013 | DEPARTMENT OF HEALTH (01) | FL |
RN9196949 | DEPARTMENT OF HEALTH (01) | FL |