Provider Demographics
NPI:1093909079
Name:BROOKINS, DEBRA L (BS)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:BROOKINS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:L
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:PO BOX 3477
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-0416
Mailing Address - Country:US
Mailing Address - Phone:541-888-0373
Mailing Address - Fax:
Practice Address - Street 1:978 NOBLE AVE
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-3129
Practice Address - Country:US
Practice Address - Phone:541-888-0373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator