Provider Demographics
NPI:1699169441
Name:ROOKS, CLARISA (ARNP)
Entity type:Individual
Prefix:
First Name:CLARISA
Middle Name:
Last Name:ROOKS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 PEPPERDINE WAY
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-3664
Mailing Address - Country:US
Mailing Address - Phone:386-717-9010
Mailing Address - Fax:
Practice Address - Street 1:101 LEXINGTON CIR
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6845
Practice Address - Country:US
Practice Address - Phone:386-717-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN245478363LF0000X
FLARNP9270667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily