Healthcare Provider Details

I. General information

NPI: 1740940519
Provider Name (Legal Business Name): ELENI MAGDALENA LOPES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELENI MAGDALENA ANDERSON FNP-C

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 BIRCH ST STE 200
DERRY NH
03038-1591
US

IV. Provider business mailing address

83 MAIN ST APT 4
AMESBURY MA
01913-2835
US

V. Phone/Fax

Practice location:
  • Phone: 603-421-2526
  • Fax:
Mailing address:
  • Phone: 207-272-0436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number086139-21
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number086139-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: