Provider Demographics
NPI:1740970300
Name:ROBERTS, BRETT (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BUTTRICK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3417
Mailing Address - Country:US
Mailing Address - Phone:603-537-1300
Mailing Address - Fax:
Practice Address - Street 1:185 PLAISTOW RD STE 2
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2840
Practice Address - Country:US
Practice Address - Phone:603-691-3771
Practice Address - Fax:603-208-3079
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH082582-23363LF0000X
NH082582-21163W00000X
MARN2358834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse