MEDICARE: KAREN BROOKS

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1972040657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN BROOKS

Provider Business Mailing Address
First Line	:	608 LELAND AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-1548
Country	:	US
Telephone Number	:	937-245-9070
Fax Number	:	937-268-5266

Provider Business Practice Location Address
First Line	:	608 LELAND AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-1548
Country	:	US
Telephone Number	:	937-245-9070
Fax Number	:	937-268-5266

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

Provider Enumeration Date	:	01/19/2017
Last Update Date	:	01/19/2017

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Directions to “ KAREN BROOKS ” Practice Location

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