Provider Demographics
NPI:1669144770
Name:BRUZZESE, BRANDEN SCOTT
Entity type:Individual
Prefix:
First Name:BRANDEN
Middle Name:SCOTT
Last Name:BRUZZESE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 PATTERSON ST STE 502
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6511
Mailing Address - Country:US
Mailing Address - Phone:615-515-1900
Mailing Address - Fax:615-292-4633
Practice Address - Street 1:2400 PATTERSON ST STE 502
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-6511
Practice Address - Country:US
Practice Address - Phone:615-515-1900
Practice Address - Fax:615-292-4633
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN209143163W00000X
TN30521363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse