Provider Demographics
NPI:1487003869
Name:BROOKS, ALEXIEUS
Entity Type:Individual
Prefix:
First Name:ALEXIEUS
Middle Name:
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 1:140 JOLIET AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-1009
Mailing Address - Country:US
Mailing Address - Phone:513-570-8718
Mailing Address - Fax:513-873-6901
Practice Address - Street 1:140 JOLIET AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-1009
Practice Address - Country:US
Practice Address - Phone:513-570-8718
Practice Address - Fax:513-870-6901
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH156335-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse