Healthcare Provider Details

I. General information

NPI: 1487693081
Provider Name (Legal Business Name): DIANE M FOLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 02/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 OLD ROLLINSFORD RD SUITE 204
DOVER NH
03820-2868
US

IV. Provider business mailing address

789 CENTRAL AVE
DOVER NH
03820-2526
US

V. Phone/Fax

Practice location:
  • Phone: 603-742-7338
  • Fax: 603-740-9528
Mailing address:
  • Phone: 603-742-7338
  • Fax: 603-740-9528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP111028
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number022961-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: