Provider Demographics
NPI:1225504475
Name:BRAZEAU, VALERIE T I (RN)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:T
Last Name:BRAZEAU
Suffix:I
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 1:10060 BAY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:MI
Mailing Address - Zip Code:48133-9304
Mailing Address - Country:US
Mailing Address - Phone:734-848-4784
Mailing Address - Fax:
Practice Address - Street 1:2413 PEMBERTON DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3176
Practice Address - Country:US
Practice Address - Phone:419-509-6009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.107414163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6910304Medicaid