Provider Demographics
NPI:1396424958
Name:KAMRUZZAMAN, BRIANNA (PMHNP)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:KAMRUZZAMAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 TOPSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BOXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01921-2623
Mailing Address - Country:US
Mailing Address - Phone:508-527-0970
Mailing Address - Fax:
Practice Address - Street 1:167 TOPSFIELD RD
Practice Address - Street 2:
Practice Address - City:BOXFORD
Practice Address - State:MA
Practice Address - Zip Code:01921-2623
Practice Address - Country:US
Practice Address - Phone:508-527-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2271616363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health