Healthcare Provider Details

I. General information

NPI: 1760449250
Provider Name (Legal Business Name): ALICE MARGARET BRAZIER C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 WALTHER BLVD
PARKVILLE MD
21234-9001
US

IV. Provider business mailing address

8800 WALTHER BLVD
PARKVILLE MD
21234-9001
US

V. Phone/Fax

Practice location:
  • Phone: 410-882-3240
  • Fax: 410-661-5093
Mailing address:
  • Phone: 410-882-3240
  • Fax: 410-661-5093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR067343
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: