Lynn Brazee, FNP
Individual provider Active NPI Family Nurse Practitioner · Newark, NY
NPI 1720004328 · NPPES record last updated Jul 31, 2012
Key facts
- NPI
- 1720004328
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 331829 (NY)
- Practice address
- 1200 Driving Park Ave
Newark, NY 14513-1057 - Phone
- (315) 359-2167
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 331829 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 331829 | NY | Yes |
Addresses
Primary practice location
1200 Driving Park Ave
Newark, NY 14513-1057
Mailing address
1425 Portland Ave
Rochester, NY 14621-3001
Phone (315) 332-2123
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02648135 | Medicaid | NY |
Other providers in Newark, NY
- Kathryn Ann Bogart
- Michele Bowersox
- Ronald James Boyd
- Timothy Francis Brady
- Wade Jason Brandt
- Allison Laura Breen
- Elizabeth Louise Brewer
- Taylor Jade Brignall
- Felicity J Brockhuizen
- Caitlin Ryan Brown
All providers in Newark, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.