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General NPI Number Information
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NPI Number | 1023353794
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Entity Type | Individual
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Provider Name | DEVON D BROOKS
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Gender | Male
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 24 HOSPITAL LN
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City | CALAIS
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State | ME
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Zip | 04619-1329
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Country | US
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Telephone | 207-454-7521
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Fax |
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Provider Business Mailing Address
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Address Line | 76 SALMON FALLS RD
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City | SOMERSWORTH
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State | NH
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Zip | 03878-2815
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Country | US
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Telephone | 207-735-5470
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 06719323
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License Number State | NH
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