1740685361 NPI number — MRS. JULIET EMERALD BRINKMAN ARNP

Table of content: MRS. JULIET EMERALD BRINKMAN ARNP (NPI 1740685361)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740685361 NPI number — MRS. JULIET EMERALD BRINKMAN ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRINKMAN
Provider First Name:
JULIET
Provider Middle Name:
EMERALD
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740685361
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 ORANGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAURICE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
51036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-330-0751
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNITY POINT
Provider Second Line Business Practice Location Address:
SIOUXLAND PACE- 1200 TRI VIEW AVE
Provider Business Practice Location Address City Name:
SIOUX CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-224-7223
Provider Business Practice Location Address Fax Number:
712-224-7250
Provider Enumeration Date:
10/24/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  102274 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: A102274 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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