Provider Demographics
NPI:1750681284
Name:BRINKMAN, ELIZABTH (RD)
Entity Type:Individual
Prefix:MS
First Name:ELIZABTH
Middle Name:
Last Name:BRINKMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12655 N 16TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-2802
Mailing Address - Country:US
Mailing Address - Phone:602-999-5314
Mailing Address - Fax:602-374-2513
Practice Address - Street 1:12655 N 16TH DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-2802
Practice Address - Country:US
Practice Address - Phone:602-999-5314
Practice Address - Fax:602-374-2513
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered