Doctor Name: | LACHELLE RENEE BRINKS |
NPI Number: | 1124313259 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | R 169549-8 |
Business Practice Address: | 5 W Main St Crosby, MN - 564411421 |
Business Phone Number: | 2185467333 |
Business Fax Number: | |
Mailing Address: | 25757 183rd St, PIERZ |
State: | MN |
Postal Code: | 563641247 |
Phone Number: | 3206303623 |
Fax Number: | |
NPI Enumeration Date: | 06/16/2011 |
NPI Last Update Date: | 06/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R 169549-8 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |