Healthcare Provider Details

I. General information

NPI: 1407980584
Provider Name (Legal Business Name): LISA RAE DELAHANTY ARNP,MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 03/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 PLEASANT ST SUITE 206
CONCORD NH
03301-2588
US

IV. Provider business mailing address

9 JACKSON DR
HOOKSETT NH
03106-1906
US

V. Phone/Fax

Practice location:
  • Phone: 603-230-7266
  • Fax: 603-230-7298
Mailing address:
  • Phone: 603-627-1314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number021491-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: