Healthcare Provider Details

I. General information

NPI: 1902253347
Provider Name (Legal Business Name): BRITTANY EIDEH R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 BALDPATE RD
GEORGETOWN MA
01833-2303
US

IV. Provider business mailing address

83 BALDPATE RD
GEORGETOWN MA
01833-2303
US

V. Phone/Fax

Practice location:
  • Phone: 978-352-2131
  • Fax: 978-352-5258
Mailing address:
  • Phone: 978-352-2131
  • Fax: 978-352-5258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number2260875
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: