Provider Demographics
NPI:1407120280
Name:BROOKS, SCHERUN MICHELLE (FNP)
Entity type:Individual
Prefix:
First Name:SCHERUN
Middle Name:MICHELLE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2668 S HARPER RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-6770
Mailing Address - Country:US
Mailing Address - Phone:662-287-7138
Mailing Address - Fax:662-287-7157
Practice Address - Street 1:2113 S TATE ST
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-7912
Practice Address - Country:US
Practice Address - Phone:662-331-1497
Practice Address - Fax:662-331-1495
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR877563363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner