Healthcare Provider Details

I. General information

NPI: 1891768313
Provider Name (Legal Business Name): CAROL A MALESKA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SCHOOL ST
BRISTOL NH
03222-3263
US

IV. Provider business mailing address

PO BOX 1327
LACONIA NH
03247-1327
US

V. Phone/Fax

Practice location:
  • Phone: 603-744-5441
  • Fax: 603-744-3698
Mailing address:
  • Phone: 603-524-3211
  • Fax: 603-527-7038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number016920-23-03
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: