Provider Demographics
NPI:1578979662
Name:BRIGHAM GARIEPY, LAURA E (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:E
Last Name:BRIGHAM GARIEPY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:E
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 30
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230
Mailing Address - Country:US
Mailing Address - Phone:413-528-9311
Mailing Address - Fax:413-644-0274
Practice Address - Street 1:444 STOCKBRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230
Practice Address - Country:US
Practice Address - Phone:413-528-8580
Practice Address - Fax:413-528-8583
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2276783363LF0000X
MA2276783363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110101740AMedicaid