Individual
BROOKE T RUSHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CBRS
Contact information
Practice address
2201 IRONWOOD PL STE 100, COEUR D ALENE, ID 83814-2670
(208) 769-4222
(844) 803-7399
Mailing address
PO BOX 1387, HAYDEN, ID 83835-1387
(208) 415-0299
(208) 625-2070
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC232146A
LICENSE
ID
Enumeration date
09/16/2019
Last updated
10/05/2020
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