Provider Demographics
NPI:1003583626
Name:CODY, BRIANA MARIE (CNP)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:MARIE
Last Name:CODY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:MARIE
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:77 OLD AMESBURY LINE RD
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-1830
Mailing Address - Country:US
Mailing Address - Phone:978-228-8221
Mailing Address - Fax:
Practice Address - Street 1:77 OLD AMESBURY LINE RD
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-1830
Practice Address - Country:US
Practice Address - Phone:978-228-8221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2278980363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily