Provider Demographics
NPI:1255101556
Name:BRINSTON, TERRI (RN)
Entity type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:
Last Name:BRINSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:WADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30441 KIM LN
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-3317
Mailing Address - Country:US
Mailing Address - Phone:313-399-1626
Mailing Address - Fax:
Practice Address - Street 1:30441 KIM LN
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-3317
Practice Address - Country:US
Practice Address - Phone:313-399-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704215799163WC0400X, 163WC1500X, 163WH0200X, 173000000X, 251J00000X, 367A00000X, 163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No173000000XOther Service ProvidersLegal Medicine
No251J00000XAgenciesNursing Care
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife