MEDICARE: MRS. RACHEL J BROOKS FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.14958	OH

General Provider Information

NPI Number	:	1801220884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHEL J BROOKS FNP-C

Provider Business Mailing Address
First Line	:	410 BIRCHARD AVE
Second Line	:
City	:	FREMONT
State	:	OH
Zip	:	43420-2967
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 BIRCHARD AVE
Second Line	:
City	:	FREMONT
State	:	OH
Zip	:	43420-2967
Country	:	US
Telephone Number	:	419-334-3869
Fax Number	:	419-334-8546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2013
Last Update Date	:	10/11/2024

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