Provider Demographics
NPI:1730563537
Name:BRIMHALL, MERIDA (RN)
Entity type:Individual
Prefix:
First Name:MERIDA
Middle Name:
Last Name:BRIMHALL
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 1:13 HOUGHTON ST # 2
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-4010
Mailing Address - Country:US
Mailing Address - Phone:413-388-3447
Mailing Address - Fax:
Practice Address - Street 1:13 HOUGHTON ST # 2
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-4010
Practice Address - Country:US
Practice Address - Phone:413-388-3447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2267019163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse