Provider Demographics
NPI:1790499648
Name:BRICKNER, MARIA ISABEL (ARNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABEL
Last Name:BRICKNER
Suffix:
Gender:F
Credentials:ARNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CHEYENNE RANCH RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-4547
Mailing Address - Country:US
Mailing Address - Phone:682-390-9956
Mailing Address - Fax:
Practice Address - Street 1:3421 CHEYENNE RANCH RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-4547
Practice Address - Country:US
Practice Address - Phone:682-390-9956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG172452363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health