Provider Demographics
NPI:1033540471
Name:BRINK, LUCY R (RN CNP)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:R
Last Name:BRINK
Suffix:
Gender:F
Credentials:RN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 TROTT AVE SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-2743
Mailing Address - Country:US
Mailing Address - Phone:320-214-7286
Mailing Address - Fax:320-214-7223
Practice Address - Street 1:1804 TROTT AVE SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-2743
Practice Address - Country:US
Practice Address - Phone:320-214-7286
Practice Address - Fax:320-214-7223
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN540363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care