MR. BRANDON PERVIS SR. (NPI# 1821405127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821405127 |
Entity Type | Individual |
Full Name | MR. BRANDON PERVIS SR. |
Credential | APRN, FNP-C |
Practice Address |
558 Chase Ave Ste 9 Waterbury CT 06704-1947 |
Mailing Address |
304 S Jones Blvd Ste 1506 Las Vegas NV 89107-2623 |
Practice Telephone | 2036282394 |
Mailing Telephone | 2036282394 |
Enumeration Date | 2014-07-18 |
Last Update Date | 2019-12-31 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 5748 | CT | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5748 | CT | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
170 Norton St, New Haven, CT 065114061 | 2037476822 |
Street Address |
558 CHASE AVE STE 9 |
City | WATERBURY |
State | CT |
Zip Code | 06704-1947 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104436757 | John Franco Deleo | Physical Therapist | 8 S Commons Road, Waterbury, CT 06704 | 2020-08-07 |
1679108492 | Sky Health Group PC | Family Medicine | 64 Blue Ridge Drive, Waterbury, CT 06704 | 2020-03-12 |
1801446554 | George Ahyia Osae Jr. | Physician Assistant | 67 Buckland Dr, Waterbury, CT 06704 | 2019-09-16 |
1730629551 | Camille Lois Thomas | Licensed Practical Nurse | 64 Santoro St, Waterbury, CT 06704 | 2017-02-27 |
1083925689 | Allan Majeski | Speech-Language Pathologist | 100 Blueridge Drive Extension, Waterbury, CT 06704 | 2010-06-29 |
1417273384 | Michael Augustine | Marriage & Family Therapist | 678 Chase Parkway, Waterbury, CT 06704 | 2010-04-16 |
1750606000 | Cheryl Lynn Wilson | Social Worker | 103 Kara Drive, Waterbury, CT 06704 | 2010-03-30 |
1821212101 | Cesar Augusto Pascal | Dentist | Waterbury Dental Care P.C., 558 Chase Avenue, Waterbury, CT 06704 | 2007-04-11 |
1639204688 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 8 South Commons Road, Waterbury, CT 06704 | 2007-02-22 |
1053850578 | Erica Jo Cracco | Pharmacist | 240 Chase Ave, Waterbury, CT 06704 | 2017-02-16 |
Find all providers in zip 06704 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316559248 | Agape Family Medical Center LLC | Nurse Practitioner | 1078 W Main St Ste 3, Waterbury, CT 06708-2651 | 2020-08-21 |
1508375080 | Christina Audet Solomito | Nurse Practitioner | 133 Scovill St Ste 306, Waterbury, CT 06706-1127 | 2017-09-27 |
1558886671 | Macaela Cirish | Nurse Practitioner | 3801 East Main Street, Second Floor, Waterbury, CT 06705 | 2017-08-09 |
1609323070 | Laila Jones | Nurse Practitioner | 170 Grandview Ave Ste 1, Waterbury, CT 06708-2577 | 2016-09-02 |
1124484357 | Melanie M.f. Nesprido | Nurse Practitioner | 60 Westwood Ave Ste 100, Waterbury, CT 06708-2460 | 2016-01-04 |
1447651690 | Matthew L Balanda | Nurse Practitioner | 1389 W Main St Ste 205, Waterbury, CT 06708-3115 | 2014-09-08 |
1831523638 | Eileen Anne Knox | Nurse Practitioner | 1253 W Main St, Waterbury, CT 06702-1418 | 2013-08-28 |
1033414867 | Steven Paul Jeske | Nurse Practitioner | 276 Highland Ave Ste A2, Waterbury, CT 06708 | 2011-01-26 |
1982853263 | Leah Lucarelli | Nurse Practitioner | 80 Phoenix Ave Ste 101, Waterbury, CT 06702-1418 | 2008-09-11 |
1891836110 | Michelle Lynn Kennedy | Nurse Practitioner | 51 N Elm St, Waterbury, CT 06702-1511 | 2007-02-09 |
Find all providers in WATERBURY |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.