Provider Demographics
NPI:1285894766
Name:BRINSON, TAMIKA LASHAWN (NP)
Entity type:Individual
Prefix:MS
First Name:TAMIKA
Middle Name:LASHAWN
Last Name:BRINSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 AMBER LEIGH WAY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-2341
Mailing Address - Country:US
Mailing Address - Phone:585-300-1504
Mailing Address - Fax:
Practice Address - Street 1:PINEVILLE REHABILITATION & LIVING CENTER
Practice Address - Street 2:1010 LAKEVIEW DR
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134
Practice Address - Country:US
Practice Address - Phone:704-889-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY587851163W00000X
NC5020749363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty