Healthcare Provider Details

I. General information

NPI: 1831661172
Provider Name (Legal Business Name): LAURA ROSSI AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2018
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 CENTRAL AVE
DOVER NH
03820-2526
US

IV. Provider business mailing address

14 MADISON AVE
GEORGETOWN MA
01833-1940
US

V. Phone/Fax

Practice location:
  • Phone: 603-742-8787
  • Fax: 603-740-2446
Mailing address:
  • Phone: 978-994-9266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN179951
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN179951
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number054209-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: