Provider Demographics
NPI:1063818011
Name:BRINKMEYER, DANA
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:BRINKMEYER
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 1:303 S HYDRAULIC ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-1908
Mailing Address - Country:US
Mailing Address - Phone:316-269-9311
Mailing Address - Fax:316-269-1444
Practice Address - Street 1:303 S HYDRAULIC ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-1908
Practice Address - Country:US
Practice Address - Phone:316-269-9311
Practice Address - Fax:316-269-1444
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1589237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist