MEDICARE: MISS TASHA BROOKS CNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374700000X	Technician	77465	NE
2	376K00000X	Nurse's Aide	24601	NE

General Provider Information

NPI Number	:	1871953489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS TASHA BROOKS CNA

Provider Business Mailing Address
First Line	:	7704 WEBSTER ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-3062
Country	:	US
Telephone Number	:	402-819-8786
Fax Number	:

Provider Business Practice Location Address
First Line	:	7704 WEBSTER ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-3062
Country	:	US
Telephone Number	:	402-819-8786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2016
Last Update Date	:	02/25/2016

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Directions to “ MISS TASHA BROOKS CNA” Practice Location

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