Provider Demographics
NPI:1932070661
Name:BRINK, ALEXA
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:BRINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:
Other - Last Name:ANNOTICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6478 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-3413
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6478 EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-3413
Practice Address - Country:US
Practice Address - Phone:216-415-4118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide