Individual provider · Type 1 NPI

Matthew Ellam, CNP

Psychiatric/Mental Health Nurse Practitioner · Brookline, MA

NPI number 1083006696 Active

Practice location

1330 Beacon St Ste 202
Brookline, MA 02446-3202

Mailing address

6 Liberty Sq # 96730
Boston, MA 02109-5800

Other practice locations

  • 6 Liberty Sq # 96730, Boston, MA 02109-5800 · (617) 286-6764

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XRN2295977 (MA)
Registered Nurse 163W00000XRN2295977 (MA)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1083006696

Matthew Ellam, CNP's National Provider Identifier is 1083006696, issued on Feb 19, 2015. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Brookline, MA. The record was last updated on Mar 5, 2021.