Provider Demographics
NPI:1952084170
Name:BRINKLEY, JULIE MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:MARIE
Last Name:BRINKLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SANDIA PARK LN
Mailing Address - Street 2:
Mailing Address - City:SANDIA PARK
Mailing Address - State:NM
Mailing Address - Zip Code:87047-9314
Mailing Address - Country:US
Mailing Address - Phone:505-263-9518
Mailing Address - Fax:
Practice Address - Street 1:520 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-3720
Practice Address - Country:US
Practice Address - Phone:505-966-1612
Practice Address - Fax:505-966-1265
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR38696163W00000X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool