Healthcare Provider Details

I. General information

NPI: 1649953068
Provider Name (Legal Business Name): BRITTANY BENT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 OCEAN AVE
REVERE MA
02151-3675
US

IV. Provider business mailing address

36 1ST AVE
BOSTON MA
02129-4557
US

V. Phone/Fax

Practice location:
  • Phone: 781-485-6300
  • Fax: 781-485-6405
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2358314
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2358314
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: