Provider Demographics
NPI:1366644775
Name:DALEHITE BRINKMANN, KATHERINE ELIZABETH (RN,MSN,CPNP,PMHNP-C)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:DALEHITE BRINKMANN
Suffix:
Gender:F
Credentials:RN,MSN,CPNP,PMHNP-C
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ELIZABETH
Other - Last Name:BRINKMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN,MSN,CPNP,PMHNP-C
Mailing Address - Street 1:1631 E 2ND ST STE D
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-4491
Mailing Address - Country:US
Mailing Address - Phone:512-472-4357
Mailing Address - Fax:512-703-1394
Practice Address - Street 1:1631 E 2ND ST STE D
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-4491
Practice Address - Country:US
Practice Address - Phone:512-804-3600
Practice Address - Fax:512-476-1469
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP111003363LP0200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX295110501Medicaid
TX295110501Medicaid