Provider Demographics
NPI:1982431300
Name:BROOKS, MEGGIN BEA
Entity type:Individual
Prefix:
First Name:MEGGIN
Middle Name:BEA
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4772 NAVY RD STE A
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-1957
Mailing Address - Country:US
Mailing Address - Phone:901-873-0930
Mailing Address - Fax:901-873-0931
Practice Address - Street 1:853 W POPLAR AVE
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2545
Practice Address - Country:US
Practice Address - Phone:901-673-1240
Practice Address - Fax:901-673-1241
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6707363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty