Provider Demographics
NPI:1083928881
Name:BRZOSKA, ASHLEY NICOLE (LPN)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:BRZOSKA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 AVON LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44253-9524
Mailing Address - Country:US
Mailing Address - Phone:216-469-9700
Mailing Address - Fax:
Practice Address - Street 1:4234 AVON LAKE RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44253-9524
Practice Address - Country:US
Practice Address - Phone:216-469-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.140638164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse