Healthcare Provider Details

I. General information

NPI: 1336567726
Provider Name (Legal Business Name): ANDREA BROOKS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 MALL RD
BURLINGTON MA
01805-0002
US

IV. Provider business mailing address

41 MALL RD
BURLINGTON MA
01805-0002
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-8000
  • Fax:
Mailing address:
  • Phone: 781-744-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN2260880
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: