Provider Demographics
NPI:1376945501
Name:BROOKS, FRANCES ELAINE
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:ELAINE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 BERGEN ROAD #408
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860
Mailing Address - Country:US
Mailing Address - Phone:803-439-5415
Mailing Address - Fax:803-426-8544
Practice Address - Street 1:750 BERGEN RD APT 408
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29860-8164
Practice Address - Country:US
Practice Address - Phone:803-439-5415
Practice Address - Fax:803-426-8544
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC658203747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant