Healthcare Provider Details

I. General information

NPI: 1114456019
Provider Name (Legal Business Name): SARAH A VAIDA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH A JOHNSON

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ROBIE RD
BRISTOL NH
03222-6063
US

IV. Provider business mailing address

101 BOULDER POINT DR STE 1
PLYMOUTH NH
03264-3170
US

V. Phone/Fax

Practice location:
  • Phone: 603-744-6200
  • Fax: 603-536-4001
Mailing address:
  • Phone: 603-536-4000
  • Fax: 603-536-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.021138
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number080018-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: