Provider Demographics
NPI:1699506741
Name:BROOKS, JESSICA KATHERINE (LPN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:KATHERINE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:KATHERINE
Other - Last Name:CURETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:20508 56TH AVE W STE 101
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7650
Mailing Address - Country:US
Mailing Address - Phone:425-678-1390
Mailing Address - Fax:
Practice Address - Street 1:20508 56TH AVE W STE 101
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-7650
Practice Address - Country:US
Practice Address - Phone:425-678-1390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60530983164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse