Gloria Brooks II, 124411-30RN
Individual provider Active NPI Medical-Surgical Registered Nurse · Pewaukee, WI
NPI 1679299333 · NPPES record last updated Oct 14, 2022
Key facts
- NPI
- 1679299333
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical-Surgical Registered Nurse 163WM0705X
- License
- 124411-30 (WI)
- Practice address
- W241N2559East Parkway Meadow C
Unit 2
Pewaukee, WI 53072 - Phone
- (262) 225-8944
- NPI assigned
- Oct 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124411-30 | WI | MD | Medical-Surgical Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse |
163WM0705X | 124411-30 | WI | Yes |
Addresses
Primary practice location
W241N2559East Parkway Meadow C
Unit 2
Pewaukee, WI 53072
Mailing address
W241N2559East Parkway Meadow C
Unit 2
Pewaukee, WI 53072
Phone (262) 225-8944
Other providers in Pewaukee, WI
- Jacqueline Borthwick
- Michael Branda
- Tonia Marie Brandt
- Kiersten Elizabeth Braun
- Cheryl Ann Breitlow
- Kathryn Anne Bruflat
- Bryan J Schwartz DDS, SC
- Jill Buchholz
- Ramona Buchlmayer
- Michael A Buckholdt
All providers in Pewaukee, WI · Medical-Surgical Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.