Basic Information
Provider Information
NPI: 1528675584
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROOKS
FirstName: SARA
MiddleName: CATHERINE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 3841 GREEN HILLS VILLAGE DR STE 200
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372152691
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3601 THE VANDERBILT CLINIC
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372325050
CountryCode: US
TelephoneNumber: 6159362000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/24/2020
LastUpdateDate: 03/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X212357TNN Nursing Service ProvidersRegistered Nurse 
363LA2200X28338TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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