Healthcare Provider Details

I. General information

NPI: 1376011759
Provider Name (Legal Business Name): ANN GIEDD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 STEWART RD
EATON CENTER NH
03832-0183
US

IV. Provider business mailing address

PO BOX 183
EATON CENTER NH
03832-0183
US

V. Phone/Fax

Practice location:
  • Phone: 404-422-6231
  • Fax: 603-452-7960
Mailing address:
  • Phone: 404-422-6231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANN MARIE B GIEDD
Title or Position: OWNER
Credential: FNP
Phone: 404-422-6231