Individual
JESSIE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 276-4100
Mailing address
25 MOUNT PLEASANT AVE, PROVIDENCE, RI 02908-5152
(401) 500-8827
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
66969
RI
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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