Individual provider Active NPI

Patricia Rose Brosseau, RN

  • Registered Nurse
  • Portland, ME
National Provider Identifier
1447852181
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN72055 Issued in ME
Practice address
420 Cumberland Ave
Portland, ME 04101-2823
Phone
(207) 523-2703
NPI assigned
Nov 9, 2020
Last updated
Nov 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN72055 ME Primary

Addresses

Primary practice location

420 Cumberland Ave
Portland, ME 04101-2823

Mailing address

420 Cumberland Ave
Portland, ME 04101-2823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN72055MEMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1447852181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CUMBERLAND AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CUMBERLAND AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012823",
            "telephone_number": "207-523-2703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSSEAU",
        "first_name": "PATRICIA",
        "middle_name": "ROSE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "RN72055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.