Healthcare Provider Details

I. General information

NPI: 1417631573
Provider Name (Legal Business Name): COURTNEY BRZYCKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 W FRYE RD
CHANDLER AZ
85224-6282
US

IV. Provider business mailing address

9553 E GARY ST
MESA AZ
85207-2611
US

V. Phone/Fax

Practice location:
  • Phone: 480-728-3000
  • Fax:
Mailing address:
  • Phone: 480-457-0457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06230521
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number228427
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: