Provider Demographics
NPI:1619553070
Name:BRINKER, JENNA ARLENE
Entity Type:Individual
Prefix:MISS
First Name:JENNA
Middle Name:ARLENE
Last Name:BRINKER
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 1:4721 TREETOP DR
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1134
Mailing Address - Country:US
Mailing Address - Phone:330-327-4431
Mailing Address - Fax:
Practice Address - Street 1:4721 TREETOP DR
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-1134
Practice Address - Country:US
Practice Address - Phone:330-327-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant