Georgia Brunelle, MSN, FNP-C, RN
Individual provider Active NPI Family Nurse Practitioner · Brookfield, NH
NPI 1053946335 · NPPES record last updated Feb 26, 2022
Key facts
- NPI
- 1053946335
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 053407-23 (NH)
- Practice address
- 23 Pike Brook Rd
Brookfield, NH 03872-7310 - Phone
- (603) 986-2273
- NPI assigned
- Mar 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240502003161 | ME | Practitioner - Nurse Practitioner | 4688014913 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053407-21 | NH | MD | Registered Nurse |
| 053407-23 | NH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| York Hospital | Current |
Accepting new patients |
Locations
15 Hospital Dr
York, ME 03909
Phone (207) 351-2478
127 Long Sands Rd
Ste 11
York, ME 03909
Phone (207) 361-3888
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 053407-21 | NH | |
| Family Nurse Practitioner | 363LF0000X | 053407-23 | NH | Yes |
Addresses
Primary practice location
23 Pike Brook Rd
Brookfield, NH 03872-7310
Mailing address
23 Pike Brook Rd
Brookfield, NH 03872-7310
Phone (603) 986-2273
Other providers in Brookfield, NH
All providers in Brookfield, NH · Family Nurse Practitioner in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.