Individual
NICOLE BRAZG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(425) 445-1865
Mailing address
33 W ONTARIO ST APT 52F, CHICAGO, IL 60654-7775
(425) 445-1865
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041465583
IL
163W00000X
Registered Nurse
RN60905606
WA
363LP0200X
Pediatric Nurse Practitioner
Primary
209018362
IL
363LP0200X
Pediatric Nurse Practitioner
AP60916521
WA
Other
Enumeration date
01/31/2019
Last updated
05/28/2020
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