Healthcare Provider Details

I. General information

NPI: 1558345868
Provider Name (Legal Business Name): TAMEKA L BROOKS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVE
FARMINGTON CT
06030-8063
US

IV. Provider business mailing address

1000 ASYLUM AVE STE 3208
HARTFORD CT
06105-1702
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-8080
  • Fax: 860-679-1430
Mailing address:
  • Phone: 860-522-7121
  • Fax: 860-522-7121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number003313
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: