Healthcare Provider Details

I. General information

NPI: 1700072857
Provider Name (Legal Business Name): GLORIA GIAVENO STRAUGHN ARNP, CS, BC, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2007
Last Update Date: 09/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 ROUTE 3A SUITE 15
BOW NH
03304-4010
US

IV. Provider business mailing address

497 HOOKSETT RD SUITE 325
MANCHESTER NH
03104-2632
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-0101
  • Fax: 603-668-2191
Mailing address:
  • Phone: 603-224-0101
  • Fax: 603-668-2191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number020052-21
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number020052-23-08
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: