Provider Demographics
NPI:1982699476
Name:BRINKS, JOSHUA S (FNP)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:S
Last Name:BRINKS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2249 WEALTHY ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-3052
Mailing Address - Country:US
Mailing Address - Phone:616-391-4600
Mailing Address - Fax:616-486-0133
Practice Address - Street 1:2249 WEALTHY ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-3052
Practice Address - Country:US
Practice Address - Phone:616-391-4600
Practice Address - Fax:616-486-0133
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704194120207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4445058Medicaid
MI500026313OtherRAILROAD MEDICARE
JB194120OtherBLUE CROSS BLUE SHIELD
MIS84304Medicare UPIN
MID16091095Medicare Oscar/Certification