Healthcare Provider Details

I. General information

NPI: 1588644181
Provider Name (Legal Business Name): JUDITH WOOD COLE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALTON FAMILY MEDICINE 82 MAIN STREET
ALTON NH
03809
US

IV. Provider business mailing address

P.O. BOX 1380
ALTON NH
03809-1380
US

V. Phone/Fax

Practice location:
  • Phone: 603-875-6151
  • Fax: 603-875-2944
Mailing address:
  • Phone: 603-875-6151
  • Fax: 603-875-2944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number018480 23 03
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: