Healthcare Provider Details

I. General information

NPI: 1043776511
Provider Name (Legal Business Name): ELIBEL MARIE ABANILLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA ELIBEL VALERO BEJERANO RN

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14A TSIENNETO ROAD SUITE 200
DERRY NH
03038
US

IV. Provider business mailing address

7 HOLLAND WAY FL 1
EXETER NH
03833-2937
US

V. Phone/Fax

Practice location:
  • Phone: 603-404-6800
  • Fax: 603-686-7244
Mailing address:
  • Phone: 603-580-6753
  • Fax: 603-580-6840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11001762
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2352375
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number091648-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: