Provider Demographics
NPI:1316110083
Name:BROOKS, MONICA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MO
Mailing Address - Zip Code:64040-1322
Mailing Address - Country:US
Mailing Address - Phone:816-850-6919
Mailing Address - Fax:816-850-5415
Practice Address - Street 1:113 W 2ND ST
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MO
Practice Address - Zip Code:64040-1322
Practice Address - Country:US
Practice Address - Phone:816-850-6919
Practice Address - Fax:816-850-5415
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002017945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist