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NPI Code Detail

MEDICARE: MISS ASHLEE ELAINE BRAZIEL PA-C

MEDICARE: MISS ASHLEE ELAINE BRAZIEL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA05058TX

General Provider Information

NPI Number : 1144366139
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ASHLEE ELAINE BRAZIEL PA-C
Provider Business Mailing Address
First Line : 127 S 500 E
Second Line : SUITE 600
City : SALT LAKE CITY
State : UT
Zip : 84102-1959
Country : US
Telephone Number : 801-587-6336
Fax Number :
Provider Business Practice Location Address
First Line : 2700 E BROAD ST
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-5899
Country : US
Telephone Number : 682-242-6470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2007
Last Update Date : 07/21/2022

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Directions to “ MISS ASHLEE ELAINE BRAZIEL PA-C” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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