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General NPI Number Information
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NPI Number | 1831551688
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Entity Type | Individual
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Provider Name | SUSAN RENE' BROOKS APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 112 HARCOURT RD STE 2
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City | MOUNT VERNON
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State | OH
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Zip | 43050-3944
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Country | US
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Telephone | 740-326-6069
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Fax | 740-326-6069
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Provider Business Mailing Address
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Address Line | 112 HARCOURT RD STE 2
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City | MOUNT VERNON
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State | OH
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Zip | 43050-3944
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Country | US
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Telephone | 740-326-6069
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Fax | 740-326-6069
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 309701
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 3017301
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 109966
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.019309
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License Number State | OH
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