Provider Demographics
NPI:1841593340
Name:BROOKS, CAROLINE ELSPETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:ELSPETH
Last Name:BROOKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:CAROLINE
Other - Middle Name:ELSPETH
Other - Last Name:QUAYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:711 H ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3464
Mailing Address - Country:US
Mailing Address - Phone:907-770-0862
Mailing Address - Fax:
Practice Address - Street 1:711 H ST STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3464
Practice Address - Country:US
Practice Address - Phone:907-770-0862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK31901163W00000X
PARN595641163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse