Provider Demographics
NPI:1639155906
Name:BROOKS, MARLINA M (NURSE)
Entity Type:Individual
Prefix:MS
First Name:MARLINA
Middle Name:M
Last Name:BROOKS
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E LYRE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98363-8618
Mailing Address - Country:US
Mailing Address - Phone:360-928-3257
Mailing Address - Fax:
Practice Address - Street 1:141 E LYRE RIVER RD
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98363-8618
Practice Address - Country:US
Practice Address - Phone:360-928-3257
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00135852163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse