Provider Demographics
NPI:1245414341
Name:BRAZ, TYLER A (APRN)
Entity Type:Individual
Prefix:MRS
First Name:TYLER
Middle Name:A
Last Name:BRAZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TYLER
Other - Middle Name:A
Other - Last Name:BRUNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC, CMT
Mailing Address - Street 1:1155 MILL ST # M14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:661 SIERRA ROSE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2060
Practice Address - Country:US
Practice Address - Phone:775-982-8255
Practice Address - Fax:775-982-8251
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA824694163W00000X
CA12066171100000X
NV813694364SA2200X, 364SG0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No171100000XOther Service ProvidersAcupuncturist
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV813694OtherNEVADA APRN LIC
NV11951599OtherCAQH NUMBER
NV11951599OtherCAQH NUMBER