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Individual

MS. IDERIA BROOKS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LICENSED PRACTICAL N

Contact information

Practice address
2965 N PIERCE ST, MILWAUKEE, WI 53212-2553
(414) 263-1579
Mailing address
2965 N PIERCE ST, MILWAUKEE, WI 53212-2553
(414) 263-1579

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
29180
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39989100
WI
Enumeration date
03/17/2006
Last updated
07/08/2007
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