Healthcare Provider Details

I. General information

NPI: 1144534298
Provider Name (Legal Business Name): ANNE MEREDITH THOMASSEN APRN,NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2010
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 TSIENNETO RD SUITE 300
DERRY NH
03038-1584
US

IV. Provider business mailing address

6 TSIENNETO RD SUITE 300
DERRY NH
03038-1584
US

V. Phone/Fax

Practice location:
  • Phone: 603-216-0400
  • Fax: 603-216-3800
Mailing address:
  • Phone: 603-216-0400
  • Fax: 603-216-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number052024-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number052024-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: