Basic Information
Provider Information
NPI: 1912438102
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRAND
FirstName: ANNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: O'CONNOR
OtherFirstName: ANNA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 15 HOSPITAL DR
Address2:  
City: YORK
State: ME
PostalCode: 039091011
CountryCode: US
TelephoneNumber: 2073512478
FaxNumber: 2073512216
Practice Location
Address1: 207 S MAIN ST
Address2:  
City: NEWMARKET
State: NH
PostalCode: 038571843
CountryCode: US
TelephoneNumber: 6036593106
FaxNumber: 6036598003
Other Information
ProviderEnumerationDate: 03/21/2017
LastUpdateDate: 12/11/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X070407-23NHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home