Provider Demographics
NPI:1750022356
Name:BROOKS, LOVENIA (CNA)
Entity Type:Individual
Prefix:
First Name:LOVENIA
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3645 BARNA AVE
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-5334
Mailing Address - Country:US
Mailing Address - Phone:321-890-6361
Mailing Address - Fax:
Practice Address - Street 1:3645 BARNA AVE
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-5334
Practice Address - Country:US
Practice Address - Phone:321-890-6361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL402074376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty