Healthcare Provider Details

I. General information

NPI: 1447889902
Provider Name (Legal Business Name): JESSIE MARGARET BRAIN MSN, FNP-C, ACHPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6106
US

IV. Provider business mailing address

75 FRANCIS ST
BOSTON MA
02115-6106
US

V. Phone/Fax

Practice location:
  • Phone: 617-632-3000
  • Fax:
Mailing address:
  • Phone: 603-785-9436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN282105
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: