Healthcare Provider Details

I. General information

NPI: 1760679476
Provider Name (Legal Business Name): ROSEMARY HYDRISKO DOUGHERTY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 MANCHESTER ST STE 5A
CONCORD NH
03301-5101
US

IV. Provider business mailing address

117 MANCHESTER ST STE 5A
CONCORD NH
03301-5101
US

V. Phone/Fax

Practice location:
  • Phone: 603-606-9357
  • Fax: 603-217-2075
Mailing address:
  • Phone: 603-606-9357
  • Fax: 603-217-2075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number034796-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: