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Individual

MRS. NICOLE A BRINK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
100 MALLARD CREEK RD STE 300, LOUISVILLE, KY 40207-5136
(502) 855-6130
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3011090
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100451640
KY
Enumeration date
02/14/2017
Last updated
04/26/2017
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