Provider Demographics
NPI:1881998078
Name:BROOKS, GINGER RACHEL (APRN)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:RACHEL
Last Name:BROOKS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:GINGER
Other - Middle Name:
Other - Last Name:REAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:4215 JOE RAMSEY BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401
Practice Address - Country:US
Practice Address - Phone:903-408-5112
Practice Address - Fax:903-408-5124
Is Sole Proprietor?:No
Enumeration Date:2011-01-02
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5375307042363LF0000X
TX1108784363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200688810BMedicaid
KS068002127OtherMEDICARE PTAN