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NPI Code Detail

MEDICARE: MS. KRYSTIN A. BRINKER PA-C

MEDICARE: MS. KRYSTIN A. BRINKER PA-C
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
1363AS0400XSurgical Physician Assistant006350GA

General Provider Information

NPI Number : 1205107620
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRYSTIN A. BRINKER PA-C
Provider Business Mailing Address
First Line : 3131 MAPLE DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30305-2515
Country : US
Telephone Number : 404-841-8450
Fax Number : 404-841-8453
Provider Business Practice Location Address
First Line : 3131 MAPLE DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30305-2515
Country : US
Telephone Number : 404-841-8450
Fax Number : 404-841-8453
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2012
Last Update Date : 04/25/2018

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