Healthcare Provider Details

I. General information

NPI: 1114338530
Provider Name (Legal Business Name): KLAVDIA S. BRISSON DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 WESTERN AVE
BRIGHTON MA
02135-1007
US

IV. Provider business mailing address

27 CONGRESS ST STE 513
SALEM MA
01970-5523
US

V. Phone/Fax

Practice location:
  • Phone: 617-783-0500
  • Fax: 617-562-1398
Mailing address:
  • Phone: 978-744-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN270633
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: