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Individual

BROOKE BAZIL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN, CRNA

Contact information

Practice address
1900 N STATE ST STE 105, PROVO, UT 84604-1354
(801) 655-5245
(801) 216-8357
Mailing address
348 W 90 S, SALEM, UT 84653-9158
(801) 885-5246

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
848972
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
7197791
UT
367500000X
Certified Registered Nurse Anesthetist
95000376
CA

Other

Enumeration date
06/08/2015
Last updated
11/11/2022
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