Provider Demographics
NPI:1124914262
Name:HEAD, BROOKLYN A
Entity type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:A
Last Name:HEAD
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 MERRYVALE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9818
Mailing Address - Country:US
Mailing Address - Phone:402-405-1682
Mailing Address - Fax:
Practice Address - Street 1:9320 MERRYVALE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9818
Practice Address - Country:US
Practice Address - Phone:402-405-1682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide