Provider Demographics
NPI:1073276671
Name:BROOKE, DEBBIE S (RN)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:S
Last Name:BROOKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 SUNRISE VISTA DR STE 3200
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7058
Mailing Address - Country:US
Mailing Address - Phone:916-385-2784
Mailing Address - Fax:916-512-3473
Practice Address - Street 1:6060 SUNRISE VISTA DR STE 3200
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7058
Practice Address - Country:US
Practice Address - Phone:916-385-2784
Practice Address - Fax:916-512-3473
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA570416163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse