Provider Demographics
NPI:1356031934
Name:BRINKERHOFF, ALLEN JOSEPH
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:JOSEPH
Last Name:BRINKERHOFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 AROBIO LN
Mailing Address - Street 2:
Mailing Address - City:LOVELOCK
Mailing Address - State:NV
Mailing Address - Zip Code:89419-5400
Mailing Address - Country:US
Mailing Address - Phone:775-442-0683
Mailing Address - Fax:
Practice Address - Street 1:1260 NEVADA PACIFIC BLVD
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-9871
Practice Address - Country:US
Practice Address - Phone:775-442-0683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA3106363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant