Provider Demographics
NPI:1396360913
Name:BRIME, ALICIA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:BRIME
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 SIERRA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6728
Mailing Address - Country:US
Mailing Address - Phone:623-521-0340
Mailing Address - Fax:
Practice Address - Street 1:5550 SIERRA RIDGE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6728
Practice Address - Country:US
Practice Address - Phone:623-521-0340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH172260164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty