Provider Demographics
NPI:1962266460
Name:BROOKS, JANEE II
Entity type:Individual
Prefix:
First Name:JANEE
Middle Name:
Last Name:BROOKS
Suffix:II
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 1:3060 WILLIAMS DR STE 300
Mailing Address - Street 2:#16
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031
Mailing Address - Country:US
Mailing Address - Phone:202-430-5065
Mailing Address - Fax:
Practice Address - Street 1:3060 WILLIAMS DR STE 300
Practice Address - Street 2:#16
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:202-430-5065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAG28147135172A00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
Yes172A00000XOther Service ProvidersDriver