Healthcare Provider Details

I. General information

NPI: 1285875716
Provider Name (Legal Business Name): MARGARET M BROOKS RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2009
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3207 N ACADEMY BLVD 100
COLORADO SPRINGS CO
80917-5100
US

IV. Provider business mailing address

PO BOX 76510
COLORADO SPRINGS CO
80970-6510
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-3600
  • Fax:
Mailing address:
  • Phone: 719-638-8844
  • Fax: 719-638-8115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number102530
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: