Provider Demographics
NPI:1760778161
Name:BRAZIL, JANA C (WHNP)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:C
Last Name:BRAZIL
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 151420
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-1420
Mailing Address - Country:US
Mailing Address - Phone:936-699-7575
Mailing Address - Fax:936-699-7576
Practice Address - Street 1:402 GASLIGHT BLVD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3123
Practice Address - Country:US
Practice Address - Phone:936-699-7575
Practice Address - Fax:936-699-7576
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX649524363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology