KODA BRINKER PMHNP-BC NPI 1043055502

NPI Information

  • NPI: 1043055502
  • Provider Name: KODA BRINKER, PMHNP-BC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 10304 EATON PL STE 100
    FAIRFAX, VA
    ZIP 22030
  • Phone: (571) 463-8620

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NPI Details

Koda Brinker, PMHNP-BC is a psychiatric/mental health nurse practitioner in Fairfax, VA. Koda Brinker, PMHNP-BC NPI is 1043055502. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10304 EATON PL STE 100
FAIRFAX, VA
ZIP 22030-221
Phone: (571) 463-8620

The enumeration date for this NPI number is 6/27/2024 and was last updated on 11/26/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthNP500013147DISTRICT OF COLUMBIANo
2363LP0808XNurse PractitionerPsychiatric/Mental Health0024190559VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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