| Doctor Name: | MS. THERESA JAINN BROOKS |
| NPI Number: | 1114966819 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP/PA-C |
| License Number: | 392031 |
| Business Practice Address: | 8495 Crater Lake Hwy 118-gv White City, OR - 975033011 |
| Business Phone Number: | 5418262111 |
| Business Fax Number: | |
| Mailing Address: | Po Box 943, GOLD HILL |
| State: | OR |
| Postal Code: | 975250943 |
| Phone Number: | 5418211919 |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2006 |
| NPI Last Update Date: | 07/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 392031 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |