Provider Demographics
NPI:1124782388
Name:BRINLEY, JOSH
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:BRINLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5635 DARLETTA ST SW
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:OH
Mailing Address - Zip Code:44662-9737
Mailing Address - Country:US
Mailing Address - Phone:330-904-9231
Mailing Address - Fax:
Practice Address - Street 1:4450 BELDEN VILLAGE ST NW STE 307
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2592
Practice Address - Country:US
Practice Address - Phone:330-499-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH137601367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered