Provider Demographics
NPI:1447994140
Name:HEALY, BRENDA M (RN)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:M
Last Name:HEALY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2009
Mailing Address - Country:US
Mailing Address - Phone:508-906-3044
Mailing Address - Fax:
Practice Address - Street 1:459 MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2009
Practice Address - Country:US
Practice Address - Phone:508-906-3044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN170643163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse