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General NPI Number Information
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NPI Number | 1235870007
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Entity Type | Individual
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Provider Name | INGRID BROZE PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 28580 ORCHARD LAKE RD STE 104
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-2988
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Country | US
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Telephone | 248-865-7271
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Fax |
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Provider Business Mailing Address
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Address Line | 28580 ORCHARD LAKE RD STE 104
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-2988
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0035674
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704381868
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License Number State | MI
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