MEDICARE: JAMES A BRIMM PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11027660	FL

General Provider Information

NPI Number	:	1386325959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES A BRIMM PMHNP

Provider Business Mailing Address
First Line	:	115 POMPANO DR SE APT A
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33705-4078
Country	:	US
Telephone Number	:	502-777-2425
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 POMPANO DR SE APT A
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33705-4078
Country	:	US
Telephone Number	:	502-777-2425
Fax Number	:

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

Provider Enumeration Date	:	07/27/2023
Last Update Date	:	07/27/2023

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