Healthcare Provider Details

I. General information

NPI: 1205764248
Provider Name (Legal Business Name): CONNECTIVE MEDICAL OF CA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 NH 101 UNIT 4
AMHERST NH
03031-8082
US

IV. Provider business mailing address

199 NH 101 UNIT 4
AMHERST NH
03031-8082
US

V. Phone/Fax

Practice location:
  • Phone: 603-864-0092
  • Fax:
Mailing address:
  • Phone: 603-864-0092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAUREN PRINCE-COLE
Title or Position: CEO
Credential:
Phone: 603-714-0449