Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 2014023728 | MO |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301100130 | MI |
Y | 207YP0228X | Pediatric Otolaryngology | 2014023728 | MO |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 4301100130 | MI |
NPI | 1487859047 |
---|---|
Provider Name | Dr. Jennifer Veraldi Brinkmeier |
First Address | Saint Louis, MO 63104-1003 |
Second Address | Saint Louis, MO 63104-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 17/02/2021 |