Healthcare Provider Details

I. General information

NPI: 1033347943
Provider Name (Legal Business Name): CATHERINE ANN BROOKS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 10/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

985524 NEBRASKA MEDICAL CENTER
OMAHA NE
68198-5524
US

IV. Provider business mailing address

12205 FRANKLIN CIR
OMAHA NE
68154-1302
US

V. Phone/Fax

Practice location:
  • Phone: 402-770-2734
  • Fax:
Mailing address:
  • Phone: 402-770-2734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number956
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6148
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: