Provider Demographics
NPI:1437411196
Name:BRAZZEL, YVONNE ALEXANDER (LPN)
Entity Type:Individual
Prefix:MISS
First Name:YVONNE
Middle Name:ALEXANDER
Last Name:BRAZZEL
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 1:196 SAINT MARYS AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1715
Mailing Address - Country:US
Mailing Address - Phone:347-898-0984
Mailing Address - Fax:
Practice Address - Street 1:196 SAINT MARYS AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1715
Practice Address - Country:US
Practice Address - Phone:347-898-0984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306731164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse