Healthcare Provider Details

I. General information

NPI: 1225848351
Provider Name (Legal Business Name): BRIANA ARLENE BROOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S 4TH ST
LOUISVILLE KY
40203-2188
US

IV. Provider business mailing address

1723 SOMERSET PL APT 10
LOUISVILLE KY
40220-3752
US

V. Phone/Fax

Practice location:
  • Phone: 502-585-9911
  • Fax:
Mailing address:
  • Phone: 502-851-9828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: