Individual
MS. SUSAN RENE' BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
112 HARCOURT RD STE 2, MOUNT VERNON, OH 43050-3944
(740) 326-6069
(740) 326-6069
Mailing address
112 HARCOURT RD STE 2, MOUNT VERNON, OH 43050-3944
(740) 326-6069
(740) 326-6069
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
309701
OH
363LA2100X
Acute Care Nurse Practitioner
109966
WV
363LA2100X
Acute Care Nurse Practitioner
3017301
KY
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.019309
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0189034
—
OH
05
—
1831551688
—
WV
01
—
H528410
MEDICARE PTAN
OH
01
—
WVD651A
MEDICARE PTAN
WV
Enumeration date
03/22/2016
Last updated
12/10/2024
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