Healthcare Provider Details

I. General information

NPI: 1427769587
Provider Name (Legal Business Name): DAVID ANIBAL APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2022
Last Update Date: 01/15/2023
Certification Date: 01/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 PLEASANT ST. MEMORIAL BUILDING, WEST, FLOOR 2
CONCORD NH
03301-2548
US

IV. Provider business mailing address

246 PLEASANT ST. MEMORIAL BUILDING, WEST, FLOOR 2
CONCORD NH
03301-2548
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-4003
  • Fax: 603-227-7526
Mailing address:
  • Phone: 603-224-4003
  • Fax: 603-227-7526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number080261-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number080261-23
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number080261-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: