Healthcare Provider Details

I. General information

NPI: 1487667499
Provider Name (Legal Business Name): ANGELA L. NELSON CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA L. ISENBARGER CNM

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 PLEASANT ST
CONCORD NH
03301-7560
US

IV. Provider business mailing address

6 NASTURTIUM TER
CONCORD NH
03303-3427
US

V. Phone/Fax

Practice location:
  • Phone: 603-226-6117
  • Fax: 603-229-5492
Mailing address:
  • Phone: 603-228-6534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number044077-23-01
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: