Healthcare Provider Details
I. General information
NPI: 1154076834
Provider Name (Legal Business Name): HANNAH MAXINE BRINK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/21/2022
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
RAF LAKENHEATH BUILDING 932
BRANDON SUFFOLK
IP27 9PN
GB
IV. Provider business mailing address
UNIT 5210 BOX 230
APO AE
09461-5210
US
V. Phone/Fax
- Phone: 314-226-8010
- Fax:
- Phone: 163-852-8010
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 0101280705 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171000000X |
| Taxonomy | Military Health Care Provider |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: