MEDICARE: GINA BRINATTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	202004	MN

General Provider Information

NPI Number	:	1114399268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA BRINATTE

Provider Business Mailing Address
First Line	:	823 5TH ST
Second Line	:
City	:	NICOLLET
State	:	MN
Zip	:	56074-2024
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1575 HOOVER DR STE A
Second Line	:
City	:	NORTH MANKATO
State	:	MN
Zip	:	56003-2669
Country	:	US
Telephone Number	:	507-387-2037
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2015
Last Update Date	:	10/28/2015

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Directions to “ GINA BRINATTE ” Practice Location

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