Provider Demographics
NPI:1336760461
Name:BRAZINSKI, EMILY RAE (CRNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RAE
Last Name:BRAZINSKI
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 1:700 HYDE AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15853-1211
Mailing Address - Country:US
Mailing Address - Phone:814-594-5001
Mailing Address - Fax:
Practice Address - Street 1:3292 STATE ROUTE 257
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-2530
Practice Address - Country:US
Practice Address - Phone:814-676-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021401363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health