Individual
MS. ANNE SUTHERLAND BRUNTRAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, CPNP-PC, CL
Contact information
Practice address
1 BROOKLINE PL STE 327, BROOKLINE, MA 02445-7238
(617) 735-8585
Mailing address
45 RUTLAND SQ, BOSTON, MA 02118-3105
(617) 818-2040
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2328766
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2328766
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2328766
REGISTERED NURSE
MA
Enumeration date
08/07/2020
Last updated
10/07/2021
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