Healthcare Provider Details

I. General information

NPI: 1679925192
Provider Name (Legal Business Name): ALMA IDRIZOVIC APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALMA BASIC

II. Dates (important events)

Enumeration Date: 07/08/2016
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT ST
CONCORD NH
03301-7559
US

IV. Provider business mailing address

11 KIMBALL DR UNIT 125
HOOKSETT NH
03106-2604
US

V. Phone/Fax

Practice location:
  • Phone: 603-622-6484
  • Fax: 603-647-8593
Mailing address:
  • Phone: 603-622-6484
  • Fax: 603-647-8593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number060838-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: