Individual
BRIAN DEAN BRAZZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
105 TEKE BURTON DR, MITCHELL, IN 47446-1208
(812) 849-3408
(812) 849-5630
Mailing address
105 TEKE BURTON DR, MITCHELL, IN 47446-1208
(812) 849-3408
(812) 849-5630
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28151328
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28151328A
RN
IN
01
—
71004232A
FNP LICENSE #
IN
01
—
71004232B
CSR PRESCRIPTIVE AUTHORITY
IN
Enumeration date
10/17/2012
Last updated
12/02/2020
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