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NPI Code Detail

MEDICARE: JEANNE D CHAREST APRN

MEDICARE: JEANNE D CHAREST APRN
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
1363LP0200XPediatric Nurse Practitioner0139452302NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20139452302OTHERNHSTATE LICENSE #
3020350051OTHERFEDERAL TAX ID
416009OTHERNHCIGNA HEALTHCARE
52308433YPNH01OTHERNHANTHEM BC/BS
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
75830418OTHERAETNA

General Provider Information

NPI Number : 1962403238
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNE D CHAREST APRN
Provider Business Mailing Address
First Line : 133 PLEASANT ST
Second Line :
City : BERLIN
State : NH
Zip : 03570-2006
Country : US
Telephone Number : 603-752-2040
Fax Number : 603-752-7797
Provider Business Practice Location Address
First Line : 133 PLEASANT ST
Second Line :
City : BERLIN
State : NH
Zip : 03570-2006
Country : US
Telephone Number : 603-752-2040
Fax Number : 603-752-7797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 03/07/2023

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