Healthcare Provider Details

I. General information

NPI: 1124157771
Provider Name (Legal Business Name): MARIE PIERRE ANDERSON GNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MERRIMACK STREET HAVERHILL FAMILY PRACTICE
HAVERHILL MA
01830
US

IV. Provider business mailing address

7 PLEASANT STREET
MERRIMAC MA
01860-1945
US

V. Phone/Fax

Practice location:
  • Phone: 978-521-6555
  • Fax:
Mailing address:
  • Phone: 978-346-4534
  • Fax: 978-346-4534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number177501
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: