Provider Demographics
NPI:1770166324
Name:COUTURE, BRIAN JOHN (RN)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:JOHN
Last Name:COUTURE
Suffix:
Gender:M
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:PO BOX 60724
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-0724
Mailing Address - Country:US
Mailing Address - Phone:508-523-1994
Mailing Address - Fax:
Practice Address - Street 1:49 PLEASANT ST STE A
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-5989
Practice Address - Country:US
Practice Address - Phone:508-523-1994
Practice Address - Fax:978-537-2274
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN238068163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty