Healthcare Provider Details

I. General information

NPI: 1841905940
Provider Name (Legal Business Name): SHANNAN L METZGER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 DUNNING ST
CLAREMONT NH
03743-2070
US

IV. Provider business mailing address

243 ELM ST
CLAREMONT NH
03743-4921
US

V. Phone/Fax

Practice location:
  • Phone: 603-542-7771
  • Fax:
Mailing address:
  • Phone: 603-542-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number064176-21
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number064176-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: