Provider Demographics
NPI:1114480092
Name:BRIZEE, DANA KING (RN)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:KING
Last Name:BRIZEE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 WATERVLIET SHAKER RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-4622
Mailing Address - Country:US
Mailing Address - Phone:518-785-1341
Mailing Address - Fax:518-785-8877
Practice Address - Street 1:475 WATERVLIET SHAKER RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-4622
Practice Address - Country:US
Practice Address - Phone:518-785-1341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY453766-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool