Provider Demographics
NPI:1114253101
Name:BRIXIE, ROSEMARY ANN (FAMILY NURSE PRACTIT)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:ANN
Last Name:BRIXIE
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17450 E HIGHWAY 4
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95215-9456
Mailing Address - Country:US
Mailing Address - Phone:209-482-1017
Mailing Address - Fax:
Practice Address - Street 1:2401 W TURNER RD
Practice Address - Street 2:SUITE 450
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-2182
Practice Address - Country:US
Practice Address - Phone:209-370-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18954363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner