Provider Demographics
NPI:1447827068
Name:BRINKMANN, HOPE JUSTINE (MS, RDN)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:JUSTINE
Last Name:BRINKMANN
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17181 COON BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:HOYLETON
Mailing Address - State:IL
Mailing Address - Zip Code:62803-1414
Mailing Address - Country:US
Mailing Address - Phone:618-559-6663
Mailing Address - Fax:
Practice Address - Street 1:17181 COON BRANCH RD
Practice Address - Street 2:
Practice Address - City:HOYLETON
Practice Address - State:IL
Practice Address - Zip Code:62803-1414
Practice Address - Country:US
Practice Address - Phone:618-559-6663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86152514133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered