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General NPI Number Information
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NPI Number | 1184330391
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Entity Type | Individual
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Provider Name | QUINESHA BROOKS
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Gender | Female
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 403 W LAGOON LN APT 1808
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City | OAK CREEK
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State | WI
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Zip | 53154-2995
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Country | US
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Telephone | 720-446-8395
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Fax |
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Provider Business Mailing Address
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Address Line | 1655 N MAYFAIR RD PO BOX 13003
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City | WAUWATOSA
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State | WI
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Zip | 53213
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Country | US
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Telephone | 720-446-8395
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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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 360924
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License Number State | WI
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