Provider Demographics
NPI:1003770322
Name:BROOKS, TACHA NICOLE
Entity type:Individual
Prefix:DR
First Name:TACHA
Middle Name:NICOLE
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 1:235 34TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-1312
Mailing Address - Country:US
Mailing Address - Phone:202-621-4498
Mailing Address - Fax:
Practice Address - Street 1:235 34TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1312
Practice Address - Country:US
Practice Address - Phone:202-621-4498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-11
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant