Provider Demographics
NPI:1962695734
Name:BRINKER, TAMMY
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:BRINKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E MAIN ST
Mailing Address - Street 2:FALK MEDICAL BLDG, 4TH FLOOR
Mailing Address - City:EVANS CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16033-1219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:217 E MAIN ST
Practice Address - Street 2:FALK MEDICAL BLDG, 4TH FLOOR
Practice Address - City:EVANS CITY
Practice Address - State:PA
Practice Address - Zip Code:16033-1219
Practice Address - Country:US
Practice Address - Phone:724-538-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP004392B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102215552 0001Medicaid
PA022635NJKMedicare PIN
PA102215552 0001Medicaid