Provider Demographics
NPI:1811532724
Name:BRUTUS, YVEDA (NP)
Entity type:Individual
Prefix:
First Name:YVEDA
Middle Name:
Last Name:BRUTUS
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 1:435 SHREWSBURY ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1689
Mailing Address - Country:US
Mailing Address - Phone:508-753-5554
Mailing Address - Fax:508-752-7245
Practice Address - Street 1:1017 TURNPIKE ST STE 31
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2855
Practice Address - Country:US
Practice Address - Phone:781-236-7342
Practice Address - Fax:508-752-7245
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-14
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2261311163WP0807X
MARN2261311363LG0600X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology