Basic Information
| Provider Information | |||||||||
| NPI: | 1760449250 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRAZIER | ||||||||
| FirstName: | ALICE | ||||||||
| MiddleName: | MARGARET | ||||||||
| NamePrefix: | |||||||||
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| Credential: | C.R.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8800 WALTHER BLVD | ||||||||
| Address2: | |||||||||
| City: | PARKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212349001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108823240 | ||||||||
| FaxNumber: | 4106615093 | ||||||||
| Practice Location | |||||||||
| Address1: | 8800 WALTHER BLVD | ||||||||
| Address2: | |||||||||
| City: | PARKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212349001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108823240 | ||||||||
| FaxNumber: | 4106615093 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2006 | ||||||||
| LastUpdateDate: | 07/17/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | R067343 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 522096682 | 01 | TRICARE NORTH | OTHER | 616059-05 | 01 | MD | BCBS | OTHER | 9676-0007 | 01 | CAREFIRST BCBS OF DC | OTHER | 093NSE-616059-05 | 01 | CAREFIRST BCBS OF MD | OTHER | 0943ER-616059-06 | 01 | CAREFIRST BCBS OF MD | OTHER | 0047 | 01 | CAREFIRST BCBS | OTHER | 093NER616059-05 | 01 | CAREFIRST BCBS OF MD | OTHER | 382950200 | 05 | MD | MEDICAID | 83-03373 | 01 | EVERCARE | OTHER |