Provider Demographics
NPI:1184282915
Name:BRIMAGE, SADE L
Entity type:Individual
Prefix:
First Name:SADE
Middle Name:L
Last Name:BRIMAGE
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 1:217 PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-2243
Mailing Address - Country:US
Mailing Address - Phone:757-977-7722
Mailing Address - Fax:
Practice Address - Street 1:217 PROSPECT RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-2243
Practice Address - Country:US
Practice Address - Phone:757-977-7722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide