Provider Demographics
NPI:1790514735
Name:CASTRO, BRIANNE ELIZABETH (FNP-BC)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:ELIZABETH
Last Name:CASTRO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5281
Mailing Address - Country:US
Mailing Address - Phone:508-679-7766
Mailing Address - Fax:
Practice Address - Street 1:534 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5281
Practice Address - Country:US
Practice Address - Phone:508-679-7766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2311269363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner