Provider Demographics
NPI:1427160639
Name:BROOKS, AUDRICIA I (MSN ARNP BC)
Entity type:Individual
Prefix:MS
First Name:AUDRICIA
Middle Name:I
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MSN ARNP BC
Other - Prefix:MS
Other - First Name:AUDRICIA
Other - Middle Name:I
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:4012 PADDOCK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-1609
Mailing Address - Country:US
Mailing Address - Phone:513-861-3100
Mailing Address - Fax:513-475-6525
Practice Address - Street 1:3200 VINE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2213
Practice Address - Country:US
Practice Address - Phone:513-861-3100
Practice Address - Fax:513-475-6525
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3696P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily