Provider Demographics
NPI:1902261985
Name:BRINN, JUDITH (CPHE)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:BRINN
Suffix:
Gender:F
Credentials:CPHE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 ISABELLA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4502
Mailing Address - Country:US
Mailing Address - Phone:915-820-7731
Mailing Address - Fax:
Practice Address - Street 1:7362 REMCON CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1623
Practice Address - Country:US
Practice Address - Phone:915-820-7731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator