Provider Demographics
NPI:1801642749
Name:BROOKS, LAUREN MCKENZIE
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MCKENZIE
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 1:501 EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-4911
Mailing Address - Country:US
Mailing Address - Phone:513-571-3648
Mailing Address - Fax:
Practice Address - Street 1:501 EUCLID ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-4911
Practice Address - Country:US
Practice Address - Phone:513-571-3648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant