Bob Brutus

Individual provider Active NPI Licensed Practical Nurse · Sharon, MA

NPI 1831805670 · NPPES record last updated Jan 25, 2023

Key facts

NPI
1831805670
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LN91561 (MA)
Practice address
257 S Walpole St
Sharon, MA 02067-1606
Phone
(617) 894-8989
NPI assigned
Jan 25, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LN91561MAMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN91561 MA Yes

Addresses

Primary practice location

257 S Walpole St
Sharon, MA 02067-1606

Mailing address

257 S Walpole St
Sharon, MA 02067-1606

Other providers in Sharon, MA

All providers in Sharon, MA · Licensed Practical Nurse in Massachusetts

Sources for this page

Verify at the official NPI Registry.