Healthcare Provider Details

I. General information

NPI: 1962932301
Provider Name (Legal Business Name): BRITTNI NUSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2017
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 DODGE ST
BEVERLY MA
01915-1711
US

IV. Provider business mailing address

50 DODGE ST
BEVERLY MA
01915-1711
US

V. Phone/Fax

Practice location:
  • Phone: 978-922-2171
  • Fax:
Mailing address:
  • Phone: 978-987-0619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA101424
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: