Provider Demographics
NPI:1679680474
Name:BRAZILE, CATHLEEN O'NEAL (RN, FNP, BC)
Entity type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:O'NEAL
Last Name:BRAZILE
Suffix:
Gender:F
Credentials:RN, FNP, BC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:CATHLEEN
Other - Last Name:BRAZILE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, FNP
Mailing Address - Street 1:4 CLEMENT WAY
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:ME
Mailing Address - Zip Code:04917-4370
Mailing Address - Country:US
Mailing Address - Phone:207-495-3323
Mailing Address - Fax:207-495-3353
Practice Address - Street 1:4 CLEMENT WAY
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:ME
Practice Address - Zip Code:04917-4370
Practice Address - Country:US
Practice Address - Phone:207-495-3323
Practice Address - Fax:207-495-3353
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP161185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
6849190161OtherDOT MEDICAL EXAMINER NUMBER
WI6770-33OtherWISCONSIN APRN LICENSE
TXAPN RXOther5563
TX114678OtherTEXAS APRN NUMBER
F0406060OtherAMERICAN ACADEMY OF N P'S
TX649921OtherBOARD OF NURSING
TX00193081OtherDPS
TX00193081OtherDPS
F0406060OtherAMERICAN ACADEMY OF N P'S