Provider Demographics
NPI:1316294788
Name:BROOKS, TITI (RN)
Entity type:Individual
Prefix:MS
First Name:TITI
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8289 CHAGRIN RD
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-4745
Mailing Address - Country:US
Mailing Address - Phone:216-571-1636
Mailing Address - Fax:
Practice Address - Street 1:8289 CHAGRIN RD
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-4745
Practice Address - Country:US
Practice Address - Phone:216-571-1636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-05
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH387822163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse