MEDICARE: JOSHUA S BRINKS FNP

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	207Q00000X	Family Medicine Physician	4704194120	MI
2	363LF0000X	Family Nurse Practitioner	4704194120	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	500026313	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	JB194120	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1982699476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA S BRINKS FNP

Provider Business Mailing Address
First Line	:	2249 WEALTHY ST SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49506-3052
Country	:	US
Telephone Number	:	616-391-4600
Fax Number	:	616-486-0133

Provider Business Practice Location Address
First Line	:	2249 WEALTHY ST SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49506-3052
Country	:	US
Telephone Number	:	616-391-4600
Fax Number	:	616-486-0133

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	02/15/2021

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Directions to “ JOSHUA S BRINKS FNP” Practice Location

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