Provider Demographics
NPI:1841625308
Name:BROOKS, DELISA LYNN (APRN,FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DELISA
Middle Name:LYNN
Last Name:BROOKS
Suffix:
Gender:F
Credentials:APRN,FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 KING KENT CT
Mailing Address - Street 2:
Mailing Address - City:SCROGGINS
Mailing Address - State:TX
Mailing Address - Zip Code:75480-3116
Mailing Address - Country:US
Mailing Address - Phone:903-400-4223
Mailing Address - Fax:
Practice Address - Street 1:2309 GILMER RD STE 101
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-2133
Practice Address - Country:US
Practice Address - Phone:903-400-4223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124351363LF0000X, 363LP0808X
AR221237363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily