Healthcare Provider Details

I. General information

NPI: 1376687756
Provider Name (Legal Business Name): SANDRA DENISE BROOKS R,N,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2007
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2983 HINSEL DR
COLUMBUS OH
43232-7717
US

IV. Provider business mailing address

2983 HINSEL DR
COLUMBUS OH
43232-7717
US

V. Phone/Fax

Practice location:
  • Phone: 914-751-9254
  • Fax:
Mailing address:
  • Phone: 914-751-9254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number179125
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: