Provider Demographics
NPI:1598578767
Name:BROOKS, KIMBERLY RENEE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RENEE
Last Name:BROOKS
Suffix:
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 1:4756 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-3781
Mailing Address - Country:US
Mailing Address - Phone:402-214-8842
Mailing Address - Fax:
Practice Address - Street 1:10935 ARLINGTON PLZ APT 1933
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-2126
Practice Address - Country:US
Practice Address - Phone:402-214-8842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home