Individual provider · Type 1 NPI
Nicole Brazg, NP
Pediatric Nurse Practitioner · Chicago, IL
NPI number
1336604644
Active
Practice location
225 E Chicago Ave
Chicago, IL 60611-2991
Mailing address
33 W Ontario St Apt 52F
Chicago, IL 60654-7775
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | RN60905606 (WA) |
| Registered Nurse | 163W00000X | 041465583 (IL) |
| Pediatric Nurse Practitioner | 363LP0200X | AP60916521 (WA) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 209018362 (IL) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1336604644
Nicole Brazg, NP's National Provider Identifier is 1336604644, issued on Jan 31, 2019. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Chicago, IL. The record was last updated on May 28, 2020.