Healthcare Provider Details

I. General information

NPI: 1699638866
Provider Name (Legal Business Name): OLIVIA GRACE PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT ST
CONCORD NH
03301-2598
US

IV. Provider business mailing address

42 PLEASANT ST
CONCORD NH
03301-4006
US

V. Phone/Fax

Practice location:
  • Phone: 603-225-2711
  • Fax:
Mailing address:
  • Phone: 844-524-6673
  • Fax: 603-415-4571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: