Provider Demographics
NPI:1154126779
Name:BROOKS, DANNY JR
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:BROOKS
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3889 CHIPPEWA ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805-8324
Mailing Address - Country:US
Mailing Address - Phone:225-410-0642
Mailing Address - Fax:
Practice Address - Street 1:3889 CHIPPEWA ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-8324
Practice Address - Country:US
Practice Address - Phone:225-410-0642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA459HIM343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)