Provider Demographics
NPI:1295013910
Name:BROOKS-WILLIAMS, LORRAINE DIONNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:DIONNE
Last Name:BROOKS-WILLIAMS
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 1:100 PUTNAM ST
Mailing Address - Street 2:PH
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06608-1045
Mailing Address - Country:US
Mailing Address - Phone:203-505-0281
Mailing Address - Fax:
Practice Address - Street 1:100 PUTNAM ST
Practice Address - Street 2:PH
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06608-1045
Practice Address - Country:US
Practice Address - Phone:203-505-0281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY523214-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse