MEDICARE: NICOLE FAUCHER OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	2377	NH

General Provider Information

NPI Number	:	1760856660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE FAUCHER OTR/L

Provider Business Mailing Address
First Line	:	40 WHITEHALL RD
Second Line	:
City	:	ROCHESTER
State	:	NH
Zip	:	03867-3225
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 WHITEHALL RD
Second Line	:
City	:	ROCHESTER
State	:	NH
Zip	:	03867-3225
Country	:	US
Telephone Number	:	603-332-7711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2015
Last Update Date	:	10/02/2017

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