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General NPI Number Information
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NPI Number | 1972901569
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Entity Type | Individual
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Provider Name | BRENDA JEAN DOS SANTOS FNP
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Gender | Female
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Dates
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Enumeration Date | 12/12/2014
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Last Update Date | 01/11/2026
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Provider Practice Location Address
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Address Line | 110 LIBERTY ST
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City | BROCKTON
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State | MA
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Zip | 02301-5674
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Country | US
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Telephone | 508-941-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 88 WASHINGTON ST
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City | TAUNTON
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State | MA
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Zip | 02780-2499
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Country | US
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Telephone | 508-588-7100
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN214408
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License Number State | MA
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