Provider Demographics
NPI:1316346521
Name:BRINER, AUDREY LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:LYNN
Last Name:BRINER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 OAK GLEN DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-3050
Mailing Address - Country:US
Mailing Address - Phone:419-350-3801
Mailing Address - Fax:
Practice Address - Street 1:2109 HUGHES DR STE 550
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-5103
Practice Address - Country:US
Practice Address - Phone:419-291-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020401321835P2201X
OH032339301835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care