Provider Demographics
NPI:1528354735
Name:BROOKS, LINDA MACKENZIE (RN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MACKENZIE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4604
Mailing Address - Country:US
Mailing Address - Phone:925-933-3291
Mailing Address - Fax:
Practice Address - Street 1:1403 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4604
Practice Address - Country:US
Practice Address - Phone:925-933-3291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-26
Last Update Date:2011-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA257709163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant