Provider Demographics
NPI:1659528719
Name:BRINKMAN, MEGAN A (RN, RCS)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:A
Last Name:BRINKMAN
Suffix:
Gender:F
Credentials:RN, RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53090-1416
Mailing Address - Country:US
Mailing Address - Phone:262-334-6168
Mailing Address - Fax:
Practice Address - Street 1:711 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-1416
Practice Address - Country:US
Practice Address - Phone:262-334-6168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI155104-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse