Provider Demographics
NPI:1578006995
Name:PELLETIER, BRITTANY (AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:
Last Name:PELLETIER
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:PEREDNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 PELHAM RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3077
Mailing Address - Country:US
Mailing Address - Phone:603-898-2244
Mailing Address - Fax:603-898-2227
Practice Address - Street 1:16 PELHAM RD STE 1
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3077
Practice Address - Country:US
Practice Address - Phone:603-898-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-03
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH086836-23363L00000X
MARN2358518363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner