Provider Demographics
NPI:1801149737
Name:PFOHL, BRITTNEY BEVERLY (NP)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:BEVERLY
Last Name:PFOHL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 BROUGHTON DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-1802
Mailing Address - Country:US
Mailing Address - Phone:530-559-1730
Mailing Address - Fax:
Practice Address - Street 1:47 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-7308
Practice Address - Country:US
Practice Address - Phone:978-744-8388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2270617363LF0000X
NY337634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily