Provider Demographics
NPI:1467702233
Name:MIZE, BRANDYE MICHELLE (RN)
Entity Type:Individual
Prefix:MS
First Name:BRANDYE
Middle Name:MICHELLE
Last Name:MIZE
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:USA MEDDAC BAVARIA
Mailing Address - Street 2:CMR 411, BLDG 700, ROSE BARRACKS
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112-0061
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USA MEDDAC BAVARIA
Practice Address - Street 2:CMR 411, BLDG 700, ROSE BARRACKS
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09112-0061
Practice Address - Country:US
Practice Address - Phone:01149966-283-4719
Practice Address - Fax:01149966-283-4721
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX689442163WA2000X, 163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN