Provider Demographics
NPI:1760449250
Name:BRAZIER, ALICE MARGARET (CRNP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:MARGARET
Last Name:BRAZIER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 WALTHER BLVD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-9001
Mailing Address - Country:US
Mailing Address - Phone:410-882-3240
Mailing Address - Fax:410-661-5093
Practice Address - Street 1:8800 WALTHER BLVD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-9001
Practice Address - Country:US
Practice Address - Phone:410-882-3240
Practice Address - Fax:410-661-5093
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR067343363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
522096682OtherTRICARE NORTH
MD616059-05OtherBCBS
9676-0007OtherCAREFIRST BCBS OF DC
093NSE-616059-05OtherCAREFIRST BCBS OF MD
0943ER-616059-06OtherCAREFIRST BCBS OF MD
0047OtherCAREFIRST BCBS
093NER616059-05OtherCAREFIRST BCBS OF MD
MD382950200Medicaid
83-03373OtherEVERCARE
MDP65460Medicare UPIN
MD382950200Medicaid
N733Medicare PIN
0943ER-616059-06OtherCAREFIRST BCBS OF MD