Provider Demographics
NPI:1912675737
Name:BROOKS, JANICE ISAAC (DNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:ISAAC
Last Name:BROOKS
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:ISAAC
Other - Last Name:BROOKS, DNP, PMHNP-BC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, PMHNP-BC
Mailing Address - Street 1:4728 SPOTTSWOOD AVE # 161
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4817
Mailing Address - Country:US
Mailing Address - Phone:901-212-4718
Mailing Address - Fax:
Practice Address - Street 1:4728 SPOTTSWOOD AVE # 161
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4817
Practice Address - Country:US
Practice Address - Phone:901-212-4718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-06
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35387363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health