Provider Demographics
NPI:1215286232
Name:BRIMEYER, STEPHANY MARIE (MPH RD LD)
Entity type:Individual
Prefix:MRS
First Name:STEPHANY
Middle Name:MARIE
Last Name:BRIMEYER
Suffix:
Gender:F
Credentials:MPH RD LD
Other - Prefix:MISS
Other - First Name:STEPHANY
Other - Middle Name:MARIE
Other - Last Name:MOTTET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4190
Mailing Address - Country:US
Mailing Address - Phone:563-421-3032
Mailing Address - Fax:
Practice Address - Street 1:865 LINCOLN RD
Practice Address - Street 2:SUITE 500
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4190
Practice Address - Country:US
Practice Address - Phone:563-421-3032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002070133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered