Provider Demographics
NPI:1912880279
Name:BROOKS, DARREYELL
Entity type:Individual
Prefix:
First Name:DARREYELL
Middle Name:
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 1:3733 OTTERBEIN AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-3633
Mailing Address - Country:US
Mailing Address - Phone:937-308-6284
Mailing Address - Fax:937-308-6284
Practice Address - Street 1:3733 OTTERBEIN AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-3633
Practice Address - Country:US
Practice Address - Phone:937-308-6284
Practice Address - Fax:937-308-6284
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant