MEDICARE: STEPHANIE BROOKS

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	347C00000X	Private Vehicle	JSC8690	OH

General Provider Information

NPI Number	:	1932821741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE BROOKS

Provider Business Mailing Address
First Line	:	311 ELM ST STE 270
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-2781
Country	:	US
Telephone Number	:	513-506-0061
Fax Number	:	513-494-7882

Provider Business Practice Location Address
First Line	:	311 ELM ST STE 270
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-2781
Country	:	US
Telephone Number	:	513-506-0061
Fax Number	:	513-494-7882

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

Provider Enumeration Date	:	09/19/2022
Last Update Date	:	10/18/2022

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Directions to “ STEPHANIE BROOKS ” Practice Location

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