Provider Demographics
NPI:1881108520
Name:BRINKLEY, VALENA DENISE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:VALENA
Middle Name:DENISE
Last Name:BRINKLEY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 TANYARD CREEK DR
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-7022
Mailing Address - Country:US
Mailing Address - Phone:706-361-3704
Mailing Address - Fax:
Practice Address - Street 1:1341 TANYARD CREEK DR
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-7022
Practice Address - Country:US
Practice Address - Phone:706-361-3704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF10170951363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty