Provider Demographics
NPI:1629287909
Name:PEABODY, BRENNA G (RN)
Entity type:Individual
Prefix:MRS
First Name:BRENNA
Middle Name:G
Last Name:PEABODY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-6203
Mailing Address - Country:US
Mailing Address - Phone:603-742-8944
Mailing Address - Fax:
Practice Address - Street 1:4 ALLEN ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-6203
Practice Address - Country:US
Practice Address - Phone:603-742-8944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH016346-21163WU0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WU0100XNursing Service ProvidersRegistered NurseUrology