Individual
CAROLYN SUE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
610 MAIN ST, LAFAYETTE, IN 47901-1451
(765) 423-2638
Mailing address
610 MAIN ST, LAFAYETTE, IN 47901-1451
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
28054074A
IN
Other
Enumeration date
01/11/2011
Last updated
01/11/2011
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