Individual
LATIDA BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
3558 TELSTAR DR, ELLENWOOD, GA 30294-1112
(217) 520-2835
Mailing address
3558 TELSTAR DR, ELLENWOOD, GA 30294-1112
(217) 520-2835
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041422032
IL
163W00000X
Registered Nurse
Primary
RN248436
GA
Other
Enumeration date
08/23/2016
Last updated
01/28/2026
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