Healthcare Provider Details

I. General information

NPI: 1669727194
Provider Name (Legal Business Name): JESSICA LAUNH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 ROUTE 101 UNIT 6
AMHERST NH
03031-1735
US

IV. Provider business mailing address

199 ROUTE 101 UNIT 6 PO BOX 6057
AMHERST NH
03031-1735
US

V. Phone/Fax

Practice location:
  • Phone: 603-673-5885
  • Fax: 603-672-7150
Mailing address:
  • Phone: 603-673-5885
  • Fax: 603-672-7150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number058072-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: