Provider Demographics
NPI:1972265379
Name:DAVIES, BRIANNA MORGAN (APRN)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MORGAN
Last Name:DAVIES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1449
Mailing Address - Street 2:
Mailing Address - City:EDGARTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02539-1449
Mailing Address - Country:US
Mailing Address - Phone:508-939-0694
Mailing Address - Fax:
Practice Address - Street 1:14 PADDOCK RD
Practice Address - Street 2:
Practice Address - City:OAK BLUFFS
Practice Address - State:MA
Practice Address - Zip Code:02557-7132
Practice Address - Country:US
Practice Address - Phone:508-939-0694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2349072363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics