Doctor Name: | NANCY BRASIC |
NPI Number: | 1073922373 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | 209011215 |
Business Practice Address: | 1835 Dixie Hwy Suite 100 Flossmoor, IL - 604221974 |
Business Phone Number: | 7087998384 |
Business Fax Number: | |
Mailing Address: | 1835 Dixie Hwy, Suite 100 FLOSSMOOR |
State: | IL |
Postal Code: | 604221974 |
Phone Number: | 7087998384 |
Fax Number: | |
NPI Enumeration Date: | 08/12/2014 |
NPI Last Update Date: | 06/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 209011215 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |