Healthcare Provider Details

I. General information

NPI: 1063512572
Provider Name (Legal Business Name): PATRICIA MARY NGARA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS PATRICIA MARY DEVINE

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VA CTR TOGUS VA MEDICAL CENTER
AUGUSTA ME
04330-6719
US

IV. Provider business mailing address

22 PELHAM LN
CONCORD NH
03301-5819
US

V. Phone/Fax

Practice location:
  • Phone: 207-623-8411
  • Fax: 207-623-5719
Mailing address:
  • Phone: 603-224-6615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number014293-23-05
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: