Healthcare Provider Details

I. General information

NPI: 1518987270
Provider Name (Legal Business Name): SUZANNE REID APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 01/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 PAGE HILL RD
BERLIN NH
03570-3531
US

IV. Provider business mailing address

7 GREENWOOD AVENUE
CONWAY NH
03818
US

V. Phone/Fax

Practice location:
  • Phone: 603-752-2300
  • Fax: 603-326-5831
Mailing address:
  • Phone: 603-447-3500
  • Fax: 603-447-5568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number101-0031292
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number056890-23-03
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: