Provider Demographics
NPI:1053792341
Name:BURBRINK, BRANDI M (AUD)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:M
Last Name:BURBRINK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:MCGRAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:115 E KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2793
Mailing Address - Country:US
Mailing Address - Phone:502-584-3573
Mailing Address - Fax:502-515-3325
Practice Address - Street 1:275 QUARTERMASTER COURT
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3669
Practice Address - Country:US
Practice Address - Phone:502-584-3573
Practice Address - Fax:502-515-3325
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY165266237700000X
KY166646231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist