Provider Demographics
NPI:1447533690
Name:BROOKS, FATEN K (RPH)
Entity type:Individual
Prefix:MRS
First Name:FATEN
Middle Name:K
Last Name:BROOKS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 PLANK RD # 600
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-4954
Mailing Address - Country:US
Mailing Address - Phone:540-785-1162
Mailing Address - Fax:540-785-1183
Practice Address - Street 1:3102 PLANK RD # 600
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-4954
Practice Address - Country:US
Practice Address - Phone:540-785-1162
Practice Address - Fax:540-785-1183
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011896183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist