Provider Demographics
NPI:1881486181
Name:CHESBROUGH, BRENT (NP)
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:CHESBROUGH
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 NEPONSET ST
Mailing Address - Street 2:MERCANTILE CENTER 12TH FLOOR
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-852-0600
Mailing Address - Fax:
Practice Address - Street 1:4 BROTHERTON WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2684
Practice Address - Country:US
Practice Address - Phone:508-721-1199
Practice Address - Fax:508-453-8019
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2355968363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner