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General NPI Number Information
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NPI Number | 1730654815
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Entity Type | Individual
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Provider Name | BRENICE DUROSEAU FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/04/2018
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 2601 N HOWARD ST
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City | BALTIMORE
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State | MD
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Zip | 21218-4666
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Country | US
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Telephone | 443-738-4731
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 N HOWARD ST
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City | BALTIMORE
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State | MD
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Zip | 21218-4666
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Country | US
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Telephone | 443-738-4731
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 7702
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R243625
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License Number State | MD
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