Provider Demographics
NPI:1104013705
Name:BROOKS, ZURIE JENNIE (LPN)
Entity Type:Individual
Prefix:
First Name:ZURIE
Middle Name:JENNIE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 HARMON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879-9063
Mailing Address - Country:US
Mailing Address - Phone:989-640-8857
Mailing Address - Fax:866-893-1253
Practice Address - Street 1:2502 HARMON RD
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-9063
Practice Address - Country:US
Practice Address - Phone:989-640-8857
Practice Address - Fax:866-893-1253
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703099318164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse