Provider Demographics
NPI:1578335998
Name:BROOKS, CHAYNACIE Y
Entity Type:Individual
Prefix:
First Name:CHAYNACIE
Middle Name:Y
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 1:127 FOX HILL LN APT D
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-2742
Mailing Address - Country:US
Mailing Address - Phone:440-319-8860
Mailing Address - Fax:
Practice Address - Street 1:127 FOX HILL LN APT D
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2742
Practice Address - Country:US
Practice Address - Phone:440-319-8860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide