Provider Demographics
NPI:1013257740
Name:BROOKS, TERRY K (NP-C)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:K
Last Name:BROOKS
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MONMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1654
Mailing Address - Country:US
Mailing Address - Phone:732-263-1220
Mailing Address - Fax:
Practice Address - Street 1:40 MONMOUTH RD
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1654
Practice Address - Country:US
Practice Address - Phone:732-263-1220
Practice Address - Fax:732-229-2235
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-16
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10663300163WC0200X
NJ26NJ00452500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine